Individual
GRANT BACKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5200 FAIRVIEW BLVD, WYOMING, MN 55092-8013
(651) 464-4611
(651) 464-7627
Mailing address
5200 FAIRVIEW BLVD, WYOMING, MN 55092-8013
(651) 464-4611
(651) 464-7627
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2725
MN
Other
Enumeration date
06/23/2021
Last updated
01/23/2023
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