Provider Demographics
NPI:1457572273
Name:DALE, KAY MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:KAY
Middle Name:MARIE
Last Name:DALE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 W. 1ST ST., 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:OIL CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16301
Mailing Address - Country:US
Mailing Address - Phone:814-677-4811
Mailing Address - Fax:
Practice Address - Street 1:100 FAIRFIELD DRIVE
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16346
Practice Address - Country:US
Practice Address - Phone:814-676-7722
Practice Address - Fax:814-676-7725
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN522907L163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical