Provider Demographics
NPI:1225627235
Name:EIDENSCHINK, DANIELLE L (APRN/CNP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:L
Last Name:EIDENSCHINK
Suffix:
Gender:F
Credentials:APRN/CNP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:E
Other - Last Name:CHELMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1827 460TH ST
Mailing Address - Street 2:
Mailing Address - City:TWIN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56584-9324
Mailing Address - Country:US
Mailing Address - Phone:218-849-1163
Mailing Address - Fax:
Practice Address - Street 1:2101 ELM ST N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2417
Practice Address - Country:US
Practice Address - Phone:701-239-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR40415363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily