Healthcare Provider Details

I. General information

NPI: 1598257297
Provider Name (Legal Business Name): KATHERINE ROSE DANIELSON CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2018
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 PAUL BUNYAN DR S STE 12
BEMIDJI MN
56601-3204
US

IV. Provider business mailing address

802 PAUL BUNYAN DR S STE 12
BEMIDJI MN
56601-3204
US

V. Phone/Fax

Practice location:
  • Phone: 218-444-4323
  • Fax:
Mailing address:
  • Phone: 218-444-4323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number451
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: