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 1:5248 8TH CT W
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-5020
Mailing Address - Country:US
Mailing Address - Phone:218-849-1163
Mailing Address - Fax:
Practice Address - Street 1:3000 32ND AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-6132
Practice Address - Country:US
Practice Address - Phone:701-364-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR40415363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily