Provider Demographics
NPI:1912569658
Name:ELVESTER, DANICA KATE GARDINER (CRNA)
Entity Type:Individual
Prefix:
First Name:DANICA
Middle Name:KATE GARDINER
Last Name:ELVESTER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:DANICA
Other - Middle Name:KATE
Other - Last Name:GARDINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:3144 CHOWEN AVE S APT 125
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5446
Mailing Address - Country:US
Mailing Address - Phone:612-386-1348
Mailing Address - Fax:
Practice Address - Street 1:2450 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1450
Practice Address - Country:US
Practice Address - Phone:612-386-1348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2379367500000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program