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General NPI Number Information
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NPI Number | 1649679473
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Entity Type | Individual
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Provider Name | DANAE BOORSMA CNP, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 10/13/2024
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Provider Practice Location Address
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Address Line | 308 4TH AVE NW STE 4
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City | AUSTIN
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State | MN
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Zip | 55912
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Country | US
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Telephone | 507-279-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 106 LATHAM ST.
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City | BROWNSDALE
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State | MN
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Zip | 55918
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Country | US
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Telephone | 507-259-2345
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 273793
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95001127
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 350609
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11556
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License Number State | MN
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