Provider Demographics
NPI:1073030201
Name:DAISY, KATHY ANN (CRNP)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:ANN
Last Name:DAISY
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 COLLEGE AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3384
Mailing Address - Country:US
Mailing Address - Phone:717-291-8512
Mailing Address - Fax:717-291-8547
Practice Address - Street 1:233 COLLEGE AVE STE 302
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3384
Practice Address - Country:US
Practice Address - Phone:717-291-8512
Practice Address - Fax:717-291-8547
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018017363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner