Mr. Jack Philip Nickerson is a Grand Rapids, Michigan based nurse anesthetist who is specialized as Anesthesia Administration nurse. Active license number of Mr. Jack Philip Nickerson is 4704234290 for Anesthesia Administration in Michigan. his current practice location is 3333 Evergreen Dr Ne, Grand Rapids. Patients can reach him at 616-364-4200 or can fax him at 616-364-7347. Mr. Jack Philip Nickerson is CRNA with specialization in Anesthesia Administration and he NPI number (Unique professional ID assigned by NPPES) is 1447262548. Mr. Jack Philip Nickerson is a certified registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists.
Complete Profile:
Mr. Jack Philip Nickerson speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Anesthesia Administration
Credentials:
CRNA
Gender:
Male
Practice Address:
3333 Evergreen Dr Ne, Grand Rapids, Michigan, 49525-9756
Phone:
616-364-4200
Fax:
616-364-7347
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
NPI Number:
1447262548
NPI Enumeration Date:
13 Aug, 2006
NPI Last Update On:
30 Aug, 2010
Medical Licenses:
Nurses can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mr. Jack Philip Nickerson are as mentioned below.
License Number
Specialization
State
Status
4704234290
Anesthesia Administration
Michigan
Primary
Other Medical Identifiers:
Other legacy medical identifiers associated with Mr. Jack Philip Nickerson such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
4612272
Medicaid
Michigan
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
3333 Evergreen Dr Ne, Grand Rapids, Michigan
Zip:
49525-9756
Phone Number:
616-364-4200
Fax Number:
616-364-7347
Patients can reach Mr. Jack Philip Nickerson at 3333 Evergreen Dr Ne, Grand Rapids, Michigan or can call to book an appointment on 616-364-4200.
Comments/ Reviews:
Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 March, 2025.