MEDICARE: KAITLYN KIMBERLY DAILY FNP-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	363LF0000X	Family Nurse Practitioner	95020674	CA

General Provider Information

NPI Number	:	1578206835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLYN KIMBERLY DAILY FNP-C

Provider Business Mailing Address
First Line	:	72757 FRED WARING DR STE 1
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-9404
Country	:	US
Telephone Number	:	760-340-5800
Fax Number	:

Provider Business Practice Location Address
First Line	:	72757 FRED WARING DR
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-9341
Country	:	US
Telephone Number	:	760-340-5800
Fax Number	:

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

Provider Enumeration Date	:	04/15/2022
Last Update Date	:	04/09/2026

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