MR. Jack Philip Nickerson CRNA

  • 1447262548 NPI Number
  • |
  • Actived: 13 years ago
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According to our database, NPI number for MR. Jack Philip Nickerson CRNA is 1447262548 and actived since Sunday, August 13 2006. MR. Jack Philip Nickerson CRNA is an individual provider specializes in Nurse Anesthetist, Certified Registered, primary practice location is 3333 Evergreen Dr Ne, Grand Rapids, MI 49525. You can also contact MR. Jack Philip Nickerson CRNA via telephone number is (616) 364-4200. Provider NPI information was last updated on 08/30/2010.

Recently Active NPIs

Overview of MR. Jack Philip Nickerson CRNA

  • NPI number: 1043870017
  • Provider type: Individual
  • Specialty: Nurse Anesthetist, Certified Registered
  • Gender: Male
  • Active since: 08/13/2006
  • Last updated: 08/30/2010

Primary Scrop of Practice

  • Taxonomy Code: 367500000X
  • Specialty: Nurse Anesthetist, Certified Registered
  • License Number: 4704234290
  • License State: MI

Provider Mailing Address

  • Address: 3333 Evergreen Dr Ne
    Grand Rapids, MI 49525
  • Phone: 616-364-4200
  • Fax: 616-364-7347

Provider Practice Location

  • Address: 3333 Evergreen Dr Ne
    Grand Rapids, MI 49525
  • Phone: 616-364-4200
  • Fax: 616-364-7347

Scope of Practice

  • Taxonomy Code: 367500000X
  • Specialty: Nurse Anesthetist, Certified Registered
  • License Number: 4704234290
  • License State: MI
  • Switch: Yes

Legacy Identifiers

  • Provider Identifier: 4612272
  • Identifier Type: Medicare Oscar/Certification
  • Identifier State: MI
  • Issuer:

Question & Answers

What is the npi number?

  • Q: What is the npi number for MR. Jack Philip Nickerson CRNA?
  • A: The npi number for MR. Jack Philip Nickerson CRNA is 1447262548.
  • Q: What are MR. Jack Philip Nickerson CRNA's specialties?
  • A: MR. Jack Philip Nickerson CRNA's specialties are Nurse Anesthetist, Certified Registered and different specialities.
  • Q: What is the medical license for MR. Jack Philip Nickerson CRNA?
  • A: The medical license number for MR. Jack Philip Nickerson CRNA is 4704234290 and issued in MI in USA.
  • Q: Where is MR. Jack Philip Nickerson CRNA practice location?
  • A: MR. Jack Philip Nickerson CRNA is practicing at 3333 Evergreen Dr Ne, Grand Rapids, MI 49525.
  • Q: How to contact MR. Jack Philip Nickerson CRNA?
  • A: You can contact MR. Jack Philip Nickerson CRNA via 616-364-4200.