Provider Demographics
NPI:1609966571
Name:DALIS, JONELL K (RN)
Entity Type:Individual
Prefix:MRS
First Name:JONELL
Middle Name:K
Last Name:DALIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2393 MORRIS CALLAWAY RD
Mailing Address - Street 2:
Mailing Address - City:APPLING
Mailing Address - State:GA
Mailing Address - Zip Code:30802-5829
Mailing Address - Country:US
Mailing Address - Phone:706-541-2219
Mailing Address - Fax:
Practice Address - Street 1:6420 POLLARDS POND RD
Practice Address - Street 2:
Practice Address - City:APPLING
Practice Address - State:GA
Practice Address - Zip Code:30802-3726
Practice Address - Country:US
Practice Address - Phone:706-541-1318
Practice Address - Fax:706-541-0753
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN077081163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health