Healthcare Provider Details

I. General information

NPI: 1831434596
Provider Name (Legal Business Name): SUZANNE MURASAKI BIRKELAND CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2012
Last Update Date: 06/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 V STREET SUITE 1200 PSSB
SACRAMENTO CA
95817
US

IV. Provider business mailing address

4150 V STREET SUITE 1200 PSSB
SACRAMENTO CA
95817
US

V. Phone/Fax

Practice location:
  • Phone: 734-936-4280
  • Fax: 734-936-9091
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704293790
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number95000879
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: