Healthcare Provider Details

I. General information

NPI: 1689563728
Provider Name (Legal Business Name): DANIELLE MARIE ELG RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 E MAIN ST
ALBERT LEA MN
56007-3920
US

IV. Provider business mailing address

2115 E MAIN ST
ALBERT LEA MN
56007-3920
US

V. Phone/Fax

Practice location:
  • Phone: 507-379-5530
  • Fax: 507-373-0019
Mailing address:
  • Phone: 507-379-5530
  • Fax: 507-373-0019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberR-1741708
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: