Individual ProviderKiersta Rose DaleyCase Manager/Care CoordinatorOther Service ProvidersPractice Address36609 45th St, Shawnee, OK 74804-8882(405) 273-1170PECOS EnrollmentBased on the most recent information from CMS, provider Kiersta Rose Daley does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1821706383Provider TypeIndividualFull NameDaley, Kiersta RoseGenderFemaleSole ProprietorNoEnumeration Date11/14/2022Last Updated3/3/2025Contact InformationPractice LocationPractice Address36609 45th St, Shawnee, OK 74804-8882Phone(405) 273-1170FaxUnlisted FaxMailing LocationMailing Address36609 45th St, Shawnee, OK 74804-8882Phone(405) 273-1170FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerCode171400000XDescriptionLicense7494Oklahoma