Provider Demographics
NPI:1053374066
Name:DAILEY, TERRI L (WHNP-C)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:L
Last Name:DAILEY
Suffix:
Gender:F
Credentials:WHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 PARRISH ST
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1728
Mailing Address - Country:US
Mailing Address - Phone:585-393-2800
Mailing Address - Fax:585-396-9275
Practice Address - Street 1:335 PARRISH ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1728
Practice Address - Country:US
Practice Address - Phone:585-393-2800
Practice Address - Fax:585-396-9275
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420508363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDD7047Medicare ID - Type Unspecified