MEDICARE: KORTNEY DALY PA-C

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	363A00000X	Physician Assistant	10278	AZ

General Provider Information

NPI Number	:	1316641905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KORTNEY DALY PA-C

Provider Business Mailing Address
First Line	:	PO BOX 73334
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85050-1039
Country	:	US
Telephone Number	:	760-310-2528
Fax Number	:

Provider Business Practice Location Address
First Line	:	10200 N 92ND ST STE 225
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85258-4536
Country	:	US
Telephone Number	:	480-697-4824
Fax Number	:	480-697-4825

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

Provider Enumeration Date	:	03/28/2023
Last Update Date	:	05/03/2024

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Directions to “ KORTNEY DALY PA-C” Practice Location

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