Healthcare Provider Details

I. General information

NPI: 1366303331
Provider Name (Legal Business Name): EMEM UDO DANIELSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1654 DIFFLEY RD STE 100
EAGAN MN
55122-2236
US

IV. Provider business mailing address

5109 W 84TH ST
BLOOMINGTON MN
55437-1305
US

V. Phone/Fax

Practice location:
  • Phone: 651-641-3900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0002X
TaxonomyNeonatal Intensive Care Registered Nurse
License Number2466205
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number684
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: