Provider Demographics
NPI:1881113199
Name:ZEDIKER, AFTON SUE (FNP-C)
Entity type:Individual
Prefix:
First Name:AFTON
Middle Name:SUE
Last Name:ZEDIKER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:AFTON
Other - Middle Name:SUE
Other - Last Name:CUPPY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:305 TAYLOR DR
Mailing Address - Street 2:
Mailing Address - City:TEA
Mailing Address - State:SD
Mailing Address - Zip Code:57064-2149
Mailing Address - Country:US
Mailing Address - Phone:605-770-7963
Mailing Address - Fax:
Practice Address - Street 1:1112 S LAKE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-5039
Practice Address - Country:US
Practice Address - Phone:605-312-5350
Practice Address - Fax:605-312-8928
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCP001265363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily