Susanna Bernier Wahlstrom, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704145513 3738661 Issued in MI

Practice address

347 Rock St
Marquette, MI 49855-4783

Phone

(906) 227-9119

Fax

(906) 228-2469

NPI assigned

Feb 4, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Susanna Bernier Braman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1912397456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 ROCK ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554783",
            "telephone_number": "906-227-9119",
            "fax_number": "906-228-2469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 ROCK ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554783",
            "telephone_number": "906-227-9119",
            "fax_number": "906-228-2469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLSTROM",
        "first_name": "SUSANNA",
        "middle_name": "BERNIER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-04",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704145513 3738661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSANNA",
            "last_name": "BRAMAN",
            "middle_name": "BERNIER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Marquette, MI
• Providers in Marquette, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.