Provider Demographics
NPI:1932598232
Name:DAILEY, DANIEAL LOREN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DANIEAL
Middle Name:LOREN
Last Name:DAILEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 STUMPTOWN RD
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:NY
Mailing Address - Zip Code:13730-2287
Mailing Address - Country:US
Mailing Address - Phone:607-226-7414
Mailing Address - Fax:
Practice Address - Street 1:391 STUMPTOWN RD
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:NY
Practice Address - Zip Code:13730-2287
Practice Address - Country:US
Practice Address - Phone:607-226-7414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-10
Last Update Date:2015-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275885-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse