Healthcare Provider Details

I. General information

NPI: 1336056381
Provider Name (Legal Business Name): LINDSAY NICOLE JERVIK CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W 69TH ST STE 100
SIOUX FALLS SD
57108-2424
US

IV. Provider business mailing address

29696 480TH AVE
HUDSON SD
57034-6513
US

V. Phone/Fax

Practice location:
  • Phone: 605-336-0635
  • Fax:
Mailing address:
  • Phone: 605-336-0635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number201641
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: