Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JACK PHILIP NICKERSON, CRNA
ActiveMR. JACK PHILIP NICKERSON, CRNA is a Certified Nurse Anesthetist (CRNA) healthcare provider located in GRAND RAPIDS, Michigan. NPI 1447262548 is currently active in the NPPES registry. Verify at CMS.
Certified Nurse Anesthetist (CRNA) · GRAND RAPIDS, MI
Registration Details
- NPI Number
- 1447262548
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 13, 2006 (19.988425032158 yrs)
- Last Updated
- Aug 30, 2010
- License
-
4704234290 (MI)
Practice Information
- Address
-
3333 EVERGREEN DR NEGRAND RAPIDS, MI, 495259756Browse MI providers · Browse ZIP 49525
- Phone
- 6163644200
- Fax
- 6163647347
- Primary Specialty
-
Certified Nurse Anesthetist (CRNA)
367500000X
Other Certified Nurse Anesthetist (CRNA) Providers in GRAND RAPIDS, MI
| Name | Credential | NPI |
|---|---|---|
| DAVID GLENN MORTON | CRNA | 1871598151 |
| CARA MORGAN | CRNA | 1245225929 |
| MS. DONNA L COPPICK | CRNA | 1457338998 |
| TERESA M KOELZER | CRNA | 1679536718 |
| MS. TAMMIE ANN KEANE | CRNA | 1225094279 |
| JANET EVELYN YSKES | CRNA | 1104867092 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.