# SHANNON LYNN BACKSTROM

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1093787616
- **Gender:** F
- **Credential:** CNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP1700X | Perinatal Nurse Practitioner | CP000442 | SD | Yes |

## Other

- **Enumeration date:** 02/07/2006
- **Last updated:** 10/10/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0407827 | MEDICA | SD |
| 05 | — | 0503706 | — | IA |
| 05 | — | 10025040700 | — | NE |
| 01 | — | 2387949 | ARAZ/ AMERICA'S PPO | SD |
| 01 | — | 248007 | BLUE CROSS | SD |
| 01 | — | 283761045259 | PREFERRED ONE | SD |
| 01 | — | 370624200 | DEPT OF LABOR | SD |
| 05 | — | 400070600 | — | MN |
| 01 | — | 57105AD05 | WPS TRICARE | SD |
| 05 | — | 6828300 | — | SD |
| 05 | — | 6828302 | — | SD |
| 01 | — | 83G56BE | CC SYSTEMS/ BLUE PLUS | MN |
| 01 | — | 924114229808 | PRIMEWEST | MN |
| 01 | — | 9244760 | DAKOTACARE | SD |
| 01 | — | HP55697 | HEALTHPARTNERS | SD |