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Individual

DANIELLE MARIE THELEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC, CPNP-AC

Contact information

Practice address
14001 RIDGEDALE DR, #100, MINNETONKA, MN 55305-1781
(952) 473-0211
(952) 473-7908
Mailing address
14001 RIDGEDALE DR, #100, MINNETONKA, MN 55305-1781
(952) 473-0211
(952) 473-7908

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R174090-3
MN
363LP0200X
Pediatric Nurse Practitioner
Primary
R174090-3
MN

Other

Enumeration date
05/13/2013
Last updated
10/27/2017
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