MOLLY C BACKSTROM (NPI# 1730521717) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730521717 |
| Entity Type | Individual |
| Full Name | MOLLY C BACKSTROM |
| Credential | NP |
| Practice Address |
4621 E Superior St Essentia Health Lakeside Clinic Duluth MN 55804-2338 |
| Practice Telephone | 2187863550 |
| Mailing Telephone | 2187863550 |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2013-10-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R 181668-8 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1730521717 | 05 | |
| MI | 1730521717 | 05 |
| Street Address |
4621 E SUPERIOR ST ESSENTIA HEALTH LAKESIDE CLINIC |
| City | DULUTH |
| State | MN |
| Zip Code | 55804-2338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104886977 | Sarah Adeen Ziring | Physical Therapist | 4621 E Superior St, Duluth, MN 55804 | 2006-03-24 |
| 1861031759 | Daniel F Kuevi Akoe | Nurse Practitioner | 4621 E Superior St, Duluth, MN 55804-2338 | 2019-12-26 |
| 1932276623 | Penny Lynn Bennett | Physical Therapist | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-11-29 |
| 1548351406 | Ingrid Louisa Nisswandt-larsen | Family Medicine | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-09-27 |
| 1043319726 | Molly Herzan Burton | Physical Therapist | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-09-21 |
| 1831204940 | The Duluth Clinic, Ltd | Pharmacy | 4621 E Superior St, Suite A, Duluth, MN 55804-2338 | 2006-08-20 |
| 1518971118 | Erik J Sather | Family Medicine | 4621 E Superior St, Duluth, MN 55804 | 2006-07-28 |
| 1023034105 | Steven Peter Phillipson | Family Medicine | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-07-14 |
| 1962428730 | Angela L. Reichart | Physician Assistant | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-07-14 |
| 1205852076 | Hugh Patrick Renier | Family Medicine | 4621 E Superior St, Duluth, MN 55804-2338 | 2006-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235593591 | Michelle Leblanc | Speech-Language Pathologist | 5017 London Rd., Duluth, MN 55804 | 2016-04-12 |
| 1346541075 | Christina Finlo | Marriage & Family Therapist | 4849 Ivanhoe St, Duluth, MN 55804 | 2010-11-11 |
| 1821301623 | Rachel Gabrielle Ashford | Social Worker | 5107 E Superior St, Duluth, MN 55804 | 2010-07-21 |
| 1932381423 | Janet Florence Lewis | Registered Nurse | 4231 Dodge Street, Duluth, MN 55804 | 2007-11-27 |
| 1245419894 | Ernest Carl Hansen | Physical Therapist | 4002 London Rd., Duluth, MN 55804 | 2007-10-31 |
| 1316011596 | Melissa J. Janzen | Chiropractor | 4731 E Superior St, Duluth, MN 55804 | 2006-11-20 |
| 1861406522 | Susan Klee Anderson | Family Medicine | 4621 E Superior St., Duluth, MN 55804 | 2006-07-28 |
| 1285831040 | Janzen Chiropractic Pa | Chiropractor | 4731 E Superior St, Duluth, MN 55804 | 2007-06-27 |
| 1912121708 | Cooley Chiropractic Clinic, Inc. | Chiropractor | 5722 Homestead Rd, Duluth, MN 55804 | 2007-04-12 |
| 1831663343 | Jennifer T Rennquist | Counselor | 5223 Glendale St, Duluth, MN 55804-1110 | 2019-01-17 |
| Find all providers in zip 55804 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033625 | Ashley Thomas | Nurse Practitioner | 3750 Venture Dr Ste E4, Duluth, GA 30096-1863 | 2020-11-03 |
| 1659978930 | Sarah Jean Mudge | Nurse Practitioner | 350 Harbor Dr, Duluth, MN 55802-2600 | 2020-10-08 |
| 1174141873 | Akiysha Collins Caine | Nurse Practitioner | 2200 Satellite Blvd Apt 117, Duluth, GA 30097-4002 | 2020-07-09 |
| 1437608684 | Salimah Chagani | Nurse Practitioner | 4855 River Green Pkwy #700, Duluth, GA 30096 | 2016-09-29 |
| 1316495773 | Lifeline Primary Care | Nurse Practitioner | 4855 River Green Pkwy Ste 700, Duluth, GA 30096-8337 | 2016-09-14 |
| 1619329661 | Stephanie Bridges | Nurse Practitioner | 3575 Koger Blvd, Ste 116, Duluth, GA 30096-7559 | 2016-07-01 |
| 1215336664 | Rachel Marie Swor | Nurse Practitioner | 1000 E 1st St Ste 204, Duluth, MN 55805-2297 | 2014-08-21 |
| 1669811410 | Laura Elizabeth Lashley | Nurse Practitioner | 3505 Duluth Park Ln Bldg 4, Duluth, GA 30096-3201 | 2013-06-14 |
| 1851638423 | Candace Jacobs Ginsberg | Nurse Practitioner | 130 N 60th Ave E, Duluth, MN 55804-2549 | 2013-01-15 |
| 1710275128 | Megan Jennie Baertsch | Nurse Practitioner | 1420 London Rd Ste 100, Duluth, MN 55805-2437 | 2011-07-19 |
| Find all providers in DULUTH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.