Individual
LINDA J. BACKUS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
4424 HARBOR VILLAGE DR, OMRO, WI 54963-8229
(920) 685-2214
Mailing address
4424 HARBOR VILLAGE DR, OMRO, WI 54963-8229
(920) 685-2214
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
68349-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38225800
—
WI
Enumeration date
04/04/2006
Last updated
07/09/2007
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