Provider Demographics
NPI:1649576703
Name:DRAKE, DANIELLE MCKENZIE (APRN CNP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MCKENZIE
Last Name:DRAKE
Suffix:
Gender:F
Credentials:APRN CNP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:MCKENZIE
Other - Last Name:COMMERFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 VETERANS DR
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-2309
Mailing Address - Country:US
Mailing Address - Phone:612-725-2000
Mailing Address - Fax:320-229-5022
Practice Address - Street 1:6350 W 143RD ST STE 200
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-2890
Practice Address - Country:US
Practice Address - Phone:952-428-1010
Practice Address - Fax:952-428-1005
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4781363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily