MEDICARE: MR. DAN DAILEY ANP

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	363LA2200X	Adult Health Nurse Practitioner	1992	CA

General Provider Information

NPI Number	:	1679521181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAN DAILEY ANP

Provider Business Mailing Address
First Line	:	405 13TH AVE NW
Second Line	:
City	:	MANDAN
State	:	ND
Zip	:	58554-2317
Country	:	US
Telephone Number	:	701-854-8245
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 N RIVER ROAD
Second Line	:
City	:	FT YATES
State	:	ND
Zip	:	58538
Country	:	US
Telephone Number	:	701-854-8245
Fax Number	:

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	03/26/2012

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