Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | ARNP9162993 | FL |
N | 363L00000X | Nurse Practitioner | ARNP9162993 | FL |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | ARNP9162993 | FL |
NPI | 1548379308 |
---|---|
Provider Name | Ms. Colleen B. Dailey |
First Address | Jacksonville, FL 32256-0532 |
Second Address | Orlando, FL 32827 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 22/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
306139600 | (05) | FL |
Q14935 | (02) |