Provider Demographics
NPI:1033632062
Name:COHEN, DANIELLE M (CNP, APRN)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:M
Last Name:COHEN
Suffix:
Gender:F
Credentials:CNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14384 107TH ST SE
Mailing Address - Street 2:
Mailing Address - City:BECKER
Mailing Address - State:MN
Mailing Address - Zip Code:55308-8905
Mailing Address - Country:US
Mailing Address - Phone:763-257-7851
Mailing Address - Fax:
Practice Address - Street 1:12800 ROLLING RIDGE RD
Practice Address - Street 2:
Practice Address - City:BECKER
Practice Address - State:MN
Practice Address - Zip Code:55308-8838
Practice Address - Country:US
Practice Address - Phone:763-261-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-21
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5289363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily