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NPI Code Detail

MEDICARE: TERESA ANNE DALY RN

MEDICARE: TERESA ANNE 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
1163W00000XRegistered Nurse201657SC
2163WS0200XSchool Registered Nurse201657SC

General Provider Information

NPI Number : 1629742143
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA ANNE DALY RN
Provider Business Mailing Address
First Line : 2685 LEEDS AVE
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29405-6861
Country : US
Telephone Number : 843-529-3130
Fax Number : 843-566-1838
Provider Business Practice Location Address
First Line : 2685 LEEDS AVE
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29405-6861
Country : US
Telephone Number : 843-529-3130
Fax Number : 843-566-1838
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2021
Last Update Date : 08/12/2021

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