Healthcare Provider Details

I. General information

NPI: 1528990967
Provider Name (Legal Business Name): SHELBY HICKMAN APRN-CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 W. 18TH ST.
SIOUX FALLS SD
57105
US

IV. Provider business mailing address

3816 S. INFIELD AVE
SIOUX FALLS SD
57110
US

V. Phone/Fax

Practice location:
  • Phone: 605-333-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number200717
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: