Active NPI
Jo Ann Samuelson, FN-P
- Nurse Practitioner
- Escanaba, MI
National Provider Identifier
1508263567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704217114
- Practice address
- 3409 Ludington St
Escanaba, MI 49829-4212 - Phone
- (906) 789-4414
- NPI assigned
- Nov 19, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704217114 | MI | Primary |
Addresses
Primary practice location
3409 Ludington St
Escanaba, MI 49829-4212
Mailing address
3409 Ludington St
Escanaba, MI 49829-4212
Phone (906) 789-4414
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416355200000",
"number": "1508263567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3409 LUDINGTON ST",
"city": "ESCANABA",
"state": "MI",
"postal_code": "498294212",
"telephone_number": "906-789-4414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3409 LUDINGTON ST",
"city": "ESCANABA",
"state": "MI",
"postal_code": "498294212",
"telephone_number": "906-789-4414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMUELSON",
"first_name": "JO ANN",
"credential": "FN-P",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-19",
"last_updated": "2014-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704217114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Escanaba, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.