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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

NICHOLAS JOHN BROOM, PA-C

Active

NICHOLAS JOHN BROOM, PA-C is a Surgical Physician Assistant healthcare provider located in BASALT, Colorado. NPI 1518779917 is currently active in the NPPES registry. Verify at CMS.

Surgical Physician Assistant · BASALT, CO

Registration Details

NPI Number
1518779917
Provider Type
Individual
Gender
Male
NPI Issued
Jan 22, 2025 (1.5952452152972 yrs)
Last Updated
Jan 22, 2025

Practice Information

Address
200 ROBINSON ST
BASALT, CO, 816218472
Browse CO providers · Browse ZIP 81621
Phone
9704761100
Primary Specialty
Surgical Physician Assistant
363AS0400X
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.