Provider Demographics
NPI:1184946238
Name:DAILEY, HEATHER GAIL (CRNA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:GAIL
Last Name:DAILEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7945 MACARTHUR BLVD
Mailing Address - Street 2:#101-235
Mailing Address - City:CABIN JOHN
Mailing Address - State:MD
Mailing Address - Zip Code:20818-0235
Mailing Address - Country:US
Mailing Address - Phone:202-964-1160
Mailing Address - Fax:
Practice Address - Street 1:7945 MACARTHUR BLVD
Practice Address - Street 2:#101-235
Practice Address - City:CABIN JOHN
Practice Address - State:MD
Practice Address - Zip Code:20818-0235
Practice Address - Country:US
Practice Address - Phone:202-964-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN960295367500000X
MDR147286367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered