Provider Demographics
NPI:1437347762
Name:DALY-STENNIS, DENISE LAVERNE (DNP, PMHNP- BC)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:LAVERNE
Last Name:DALY-STENNIS
Suffix:
Gender:F
Credentials:DNP, PMHNP- BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-4304
Mailing Address - Country:US
Mailing Address - Phone:352-565-7518
Mailing Address - Fax:
Practice Address - Street 1:717 SW MARTIN LUTHER KING JR AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-1435
Practice Address - Country:US
Practice Address - Phone:800-539-4228
Practice Address - Fax:352-565-4131
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1626672363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN601106900OtherMAGELLAN
FL308824300Medicaid
TNQ020741Medicaid
TNQ020741Medicaid