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General NPI Number Information
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NPI Number | 1154095719
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Entity Type | Individual
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Provider Name | ERIKA LYNN SOUTH APRN
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Gender | Female
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Dates
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Enumeration Date | 08/05/2021
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 8333 FELCH ST STE 200
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City | ZEELAND
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State | MI
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Zip | 49464-2609
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Country | US
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Telephone | 616-748-2850
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Fax |
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Provider Business Mailing Address
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Address Line | 100 MICHIGAN ST NE # MC845
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2560
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 113726
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704308546
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License Number State | MI
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