MEDICARE: SHANNON MICHELLE HEARD NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	CP003328	SD
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	G188672	IA

General Provider Information

NPI Number	:	1205666286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON MICHELLE HEARD NP

Provider Business Mailing Address
First Line	:	317 N MAIN AVE STE 100
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57104-6004
Country	:	US
Telephone Number	:	605-800-7477
Fax Number	:

Provider Business Practice Location Address
First Line	:	317 N MAIN AVE STE 100
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57104-6004
Country	:	US
Telephone Number	:	605-800-7477
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2024
Last Update Date	:	01/27/2026

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Directions to “ SHANNON MICHELLE HEARD NP” Practice Location

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