Provider Demographics
NPI:1972223600
Name:DAILY, SAMANTHA (CNS)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:DAILY
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10228 HUNTERS CROSSING BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46239-8101
Mailing Address - Country:US
Mailing Address - Phone:317-509-5318
Mailing Address - Fax:
Practice Address - Street 1:13000 E 136TH ST
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9478
Practice Address - Country:US
Practice Address - Phone:317-442-0819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28216526A364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical