Healthcare Provider Details

I. General information

NPI: 1477941409
Provider Name (Legal Business Name): CRAIG DAILEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2014
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE MLC 11024
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE MLC 11024
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4459
  • Fax:
Mailing address:
  • Phone: 513-636-4459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN.322847-COA1
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: