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General NPI Number Information
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NPI Number | 1184332116
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Entity Type | Individual
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Provider Name | JUSTIN EDWARD DAILEY FNP-C
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Gender | Male
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Dates
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Enumeration Date | 11/08/2022
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 201 PLUMTREE RD STE 210
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City | BEL AIR
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State | MD
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Zip | 21015-6053
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Country | US
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Telephone | 410-569-0026
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Fax |
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Provider Business Mailing Address
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Address Line | 10200 GRAND CENTRAL AVE STE 220
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City | OWINGS MILLS
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State | MD
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Zip | 21117-4366
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R211723
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R211723
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License Number State | MD
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