Provider Demographics
NPI:1972058444
Name:DALEY, JACQUELINE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:DALEY
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:925 WOODLAND BRK
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-5578
Mailing Address - Country:US
Mailing Address - Phone:770-728-5983
Mailing Address - Fax:
Practice Address - Street 1:925 WOODLAND BRK
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-5578
Practice Address - Country:US
Practice Address - Phone:770-728-5983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN202657363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily