Provider Demographics
NPI:1972893717
Name:BERNSTROM, SILVIA
Entity Type:Individual
Prefix:
First Name:SILVIA
Middle Name:
Last Name:BERNSTROM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SILVIA
Other - Middle Name:
Other - Last Name:BERNSTROM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:324 E 35TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-4580
Mailing Address - Country:US
Mailing Address - Phone:612-827-7181
Mailing Address - Fax:612-767-4545
Practice Address - Street 1:1508 E FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2157
Practice Address - Country:US
Practice Address - Phone:612-871-3700
Practice Address - Fax:612-871-3705
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6938363LF0000X
MN195462-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse