DR. SUSAN ANNE WALSTRA M.D.
NPI 1790076453
Specialist in Fort Wayne, IN

Q: What is Susan Walstra's NPI number?

The NPI number for Susan Walstra is 1790076453. It was assigned to this individual provider in the NPPES registry on April 28, 2011.

Q: What is Susan Walstra's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Susan Walstra was last updated on April 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 28, 2011

4601 HEATHERWIND DR, APT. D, FORT WAYNE, IN 46815(260) 420-1433(260) 745-3643 Get Directions Write a Review

NPPES record last updated: April 28, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Susan Anne Walstra M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SUSAN ANNE WALSTRA M.D. (NPI 1790076453) is an individual specialist in Fort Wayne, Indiana, licensed in Indiana (01034161A) and active in the NPI registry since April 2011.

NPPES Registry Identity

NPI1790076453

Entity TypeIndividualFemale

Primary Taxonomy174400000X

Provider Legal NameDR. SUSAN ANNE WALSTRACredential: M.D.

Location Address4601 HEATHERWIND DR, APT. DFort Wayne, IN 46815-7135

Mailing Address4601 Heatherwind Dr, Apt. DFort Wayne, IN 46815-7135 · (260) 420-1433 · Fax (260) 745-3643

Phone(260) 420-1433

Fax(260) 745-3643

Sole ProprietorYes

Enumeration DateApril 28, 2011

✔ NPI 1790076453 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in IN · 01034161A

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

4601 HEATHERWIND DR, Fort Wayne, IN 46815

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Susan Walstra's NPI number?

The NPI number for Susan Walstra is 1790076453. It was assigned to this individual provider in the NPPES registry on April 28, 2011.

Where is Susan Walstra located?

Susan Walstra practices at 4601 Heatherwind Dr Apt. D, Fort Wayne, IN 46815. The listed phone number is (260) 420-1433.

What is Susan Walstra's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Susan Walstra was last updated on April 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.