Provider Demographics
NPI:1720634850
Name:ANGELL, DANNIELLE ELYSS
Entity Type:Individual
Prefix:
First Name:DANNIELLE
Middle Name:ELYSS
Last Name:ANGELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 CENTER ST E
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:MN
Mailing Address - Zip Code:55991-1900
Mailing Address - Country:US
Mailing Address - Phone:507-259-3366
Mailing Address - Fax:507-607-8522
Practice Address - Street 1:242 CENTER ST E
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:MN
Practice Address - Zip Code:55991-1900
Practice Address - Country:US
Practice Address - Phone:507-259-3366
Practice Address - Fax:507-607-8522
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker