Elizabeth Jane Davidson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

12314 Issued in MN

Practice address

9825 Hospital Dr
Maple Grove, MN 55369-4479

Phone

(612) 293-7822

NPI assigned

Mar 5, 2025

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mittal Dermatology, PAGroup PAC ID 5193194728, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mittal Dermatology PA

  • Dermatology Physician
  • Plymouth, MN
  • NPI 1043947286
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1741132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741132800000",
    "number": "1245038371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9859 51ST ST NE",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553767506",
            "telephone_number": "218-205-4996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9825 HOSPITAL DR",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694479",
            "telephone_number": "612-293-7822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "ELIZABETH",
        "middle_name": "JANE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-05",
        "last_updated": "2025-03-05",
        "certification_date": "2025-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "12314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielson Chiropractic LLC
• Allison Danielson, DC
• Bushra Sikander Dar, MD
• Kayleigh M Darling, PSY.D.
• Raymond Peter Davey, MA
• Jennifer Renee Davis, RD,CD, LD, CDCES
• Nardos Dawit
• Valerie Dean, LPC
• Alissa Deardorff, OTR/L
• Brianna Marie Deboer, LMT

• Family Nurse Practitioner in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.