Healthcare Provider Details

I. General information

NPI: 1659693380
Provider Name (Legal Business Name): KRISTINE KAY DALY PHARM D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2010
Last Update Date: 02/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13450 W MAPLE RD
OMAHA NE
68164-2420
US

IV. Provider business mailing address

13450 W MAPLE RD
OMAHA NE
68164-2420
US

V. Phone/Fax

Practice location:
  • Phone: 402-492-2605
  • Fax: 402-445-2514
Mailing address:
  • Phone: 402-492-2605
  • Fax: 402-445-2514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11312
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: