MEDICARE: LISA KAY DANLEY

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	1-106386	AL

General Provider Information

NPI Number	:	1831763499
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA KAY DANLEY

Provider Business Mailing Address
First Line	:	4725 MOBILE HWY STE B
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36108-5126
Country	:	US
Telephone Number	:	334-874-8800
Fax Number	:	334-593-8819

Provider Business Practice Location Address
First Line	:	2611 WOODLEY PARK DR
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-3834
Country	:	US
Telephone Number	:	334-874-8800
Fax Number	:

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

Provider Enumeration Date	:	05/18/2021
Last Update Date	:	05/18/2021

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Directions to “ LISA KAY DANLEY ” Practice Location

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