MEDICARE: MARY ANN DALY RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	101-0011838	VT

General Provider Information

NPI Number	:	1023200995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ANN DALY RN

Provider Business Mailing Address
First Line	:	PO BOX 372
Second Line	:
City	:	HARTLAND
State	:	VT
Zip	:	05048-0372
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 COLLEGE DR
Second Line	:
City	:	CLAREMONT
State	:	NH
Zip	:	03743-9707
Country	:	US
Telephone Number	:	603-542-7744
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2007
Last Update Date	:	08/15/2007

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