Provider Demographics
NPI:1255153250
Name:DALY, CHRISTINA (FNP-BC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:DALY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 ISLAND SOUND CT
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-4896
Mailing Address - Country:US
Mailing Address - Phone:407-340-2229
Mailing Address - Fax:
Practice Address - Street 1:740 CONCOURSE PKWY S STE 200
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-8101
Practice Address - Country:US
Practice Address - Phone:407-644-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035742363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily