Basic Information
| Provider Information | |||||||||
| NPI: | 1780124925 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DAILEY | ||||||||
| FirstName: | KATLYN | ||||||||
| MiddleName: | DAWN | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 841 STEUBENVILLE AVE. | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8556927247 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 841 STEUBENVILLE AVE | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 437252301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8556927247 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2017 | ||||||||
| LastUpdateDate: | 06/29/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | APRN.CNP.0028887 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health | 163W00000X | RN.404501 | OH | N | Nursing Service Providers | Registered Nurse | 163WP0808X | RN.404501 | OH | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.