Provider Demographics
NPI:1124312509
Name:ERICKSON, TONIA KAY (ARNP)
Entity type:Individual
Prefix:
First Name:TONIA
Middle Name:KAY
Last Name:ERICKSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1413 NW 32ND ST
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-7974
Mailing Address - Country:US
Mailing Address - Phone:515-321-6488
Mailing Address - Fax:515-686-8003
Practice Address - Street 1:1413 NW 32ND ST
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-7974
Practice Address - Country:US
Practice Address - Phone:515-321-6488
Practice Address - Fax:515-686-8003
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-064002363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner