Provider Demographics
NPI:1740502210
Name:DEAN, DANIELA G (RN, CNP)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:G
Last Name:DEAN
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:M
Other - Last Name:GARTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CNP
Mailing Address - Street 1:3300 OAKDALE AVE N
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2926
Mailing Address - Country:US
Mailing Address - Phone:763-581-4260
Mailing Address - Fax:763-581-4261
Practice Address - Street 1:3300 OAKDALE AVE N
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2926
Practice Address - Country:US
Practice Address - Phone:763-581-4260
Practice Address - Fax:763-581-4261
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 161950-0363LG0600X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner