Provider Demographics
NPI:1366223919
Name:GRONEWOLD, DANIELLE CHRISTINE (FNP)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:CHRISTINE
Last Name:GRONEWOLD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:DANIELLE
Other - Middle Name:CHRISTINE
Other - Last Name:ROBEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:121 DREW AVE SE
Mailing Address - Street 2:
Mailing Address - City:MADELIA
Mailing Address - State:MN
Mailing Address - Zip Code:56062-1841
Mailing Address - Country:US
Mailing Address - Phone:507-642-5200
Mailing Address - Fax:507-642-5218
Practice Address - Street 1:200 E PRINCE ST
Practice Address - Street 2:
Practice Address - City:LAKE CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:56055-2043
Practice Address - Country:US
Practice Address - Phone:507-642-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10101363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily