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Individual

SHANNON LYNN BACKSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
1417 S. CLIFF AVE., STE. 100, SIOUX FALLS, SD 57105-1063
(605) 322-8937
(605) 322-8938
Mailing address
PO BOX 86370, SIOUX FALLS, SD 57118-6370
(605) 322-7510
(605) 322-6475

Taxonomy

Speciality
Code
Description
License number
State
363LP1700X
Perinatal Nurse Practitioner
Primary
CP000442
SD

Other

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
Enumeration date
02/07/2006
Last updated
10/10/2018
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