Provider Demographics
NPI:1154044220
Name:DANIELSON, NOEL ELIZABETH (DNP)
Entity type:Individual
Prefix:DR
First Name:NOEL
Middle Name:ELIZABETH
Last Name:DANIELSON
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:NOEL
Other - Middle Name:ELIZABETH
Other - Last Name:WARMBOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 5TH ST
Mailing Address - Street 2:
Mailing Address - City:NASHWAUK
Mailing Address - State:MN
Mailing Address - Zip Code:55769-1139
Mailing Address - Country:US
Mailing Address - Phone:218-969-7522
Mailing Address - Fax:
Practice Address - Street 1:1601 GOLF COURSE RD
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-8648
Practice Address - Country:US
Practice Address - Phone:218-326-3401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9556363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner