Provider Demographics
NPI:1205661022
Name:JOHNSON, DANAE ESPERANZA
Entity type:Individual
Prefix:
First Name:DANAE
Middle Name:ESPERANZA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:DANAE
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4312 HAMPSHIRE AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55428-5252
Mailing Address - Country:US
Mailing Address - Phone:218-731-8785
Mailing Address - Fax:
Practice Address - Street 1:1121 JACKSON ST NE STE 100
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-3051
Practice Address - Country:US
Practice Address - Phone:612-353-6293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula