Lucy P Backward, RN

Individual provider Active NPI Registered Nurse · Pine Ridge, SD

NPI 1669631925 · NPPES record last updated Jun 3, 2008

Key facts

NPI
1669631925
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
R023658 (SD)
Practice address
US Hwy 18
Pine Ridge, SD 57770-1201
Phone
(605) 867-5131
Fax
(605) 867-3263
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R023658SDMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R023658 SD Yes

Addresses

Primary practice location

US Hwy 18
Pine Ridge, SD 57770-1201

Mailing address

US Hiway 18
Pine Ridge, SD 57770-1201
Phone (605) 867-5131

Other providers in Pine Ridge, SD

All providers in Pine Ridge, SD · Registered Nurse in South Dakota

Sources for this page

Verify at the official NPI Registry.