Micala Sue Danielson, CNP
Individual provider Active NPI Family Nurse Practitioner · Glenwood, MN
NPI 1003581935 · NPPES record last updated Aug 12, 2021
Key facts
- NPI
- 1003581935
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 8384 (MN)
- Practice address
- 10 4TH Ave SE
Glenwood, MN 56334-1820 - Phone
- (320) 634-5157
- NPI assigned
- Aug 12, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Glacial Ridge Hospital District
Practice addresses (Care Compare)
417 Franklin St S
Glenwood, MN 56334-1518
Phone (320) 634-5157
707 E 7TH St
PO Box 70
Starbuck, MN 56381-9546
Phone (320) 239-2200
Hospital & facility affiliations
- Glacial Ridge Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211103000732 | MN | Practitioner - Nurse Practitioner | 0749678555 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8384 | MN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Glacial Ridge Hospital District | Current |
Accepting new patients | |
| Glacial Ridge Hospital District | Current | Accepting new patients | |
| Glacial Ridge Hospital District | Current |
Accepting new patients | |
| Glacial Ridge Hospital District | Current | Accepting new patients |
Locations
10 4th Ave SE
Glenwood, MN 56334
Phone (320) 634-5157
417 Franklin St S
Glenwood, MN 56334
Phone (320) 634-5157
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/glac-1755385c
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 8384 | MN | Yes |
Addresses
Primary practice location
10 4TH Ave SE
Glenwood, MN 56334-1820
Mailing address
32523 State Highway 55
Farwell, MN 56327-2056
Phone (320) 491-5786
Other providers in Glenwood, MN
- Sharon Lynn Braaten
- Cassandra Brix
- Roderick Benjamin Brown
- Dana Lyn Citrowske Lee
- Erin R Dahlke
- Craig D Dejong
- Dental Health Services Minnewaska PLLC
- Michael David Flaten
- Tanya Freske
- Raelin McKae Friese
All providers in Glenwood, MN · Family Nurse Practitioner in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.