Provider Demographics
NPI:1437936507
Name:VAN SURKSUM, ERICA DANIELLE (DNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:DANIELLE
Last Name:VAN SURKSUM
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:DANIELLE
Other - Last Name:DYKSTRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2900 E 51ST ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-5370
Mailing Address - Country:US
Mailing Address - Phone:605-370-3834
Mailing Address - Fax:
Practice Address - Street 1:1202 21ST AVE
Practice Address - Street 2:
Practice Address - City:ROCK VALLEY
Practice Address - State:IA
Practice Address - Zip Code:51247-1420
Practice Address - Country:US
Practice Address - Phone:712-476-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR047527163W00000X
IAA176347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse