Provider Demographics
NPI:1568916195
Name:DALEY, TANISHA
Entity Type:Individual
Prefix:MRS
First Name:TANISHA
Middle Name:
Last Name:DALEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 THE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-1920
Mailing Address - Country:US
Mailing Address - Phone:561-480-0386
Mailing Address - Fax:
Practice Address - Street 1:1102 THE POINTE DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-1920
Practice Address - Country:US
Practice Address - Phone:561-480-0386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9404718163W00000X, 163WG0600X, 163WH0200X, 163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WW0000XNursing Service ProvidersRegistered NurseWound Care