NICHOLUS KOPACKI PA NPI 1417112004

NPI Information

NPI: 1417112004
Provider Name: NICHOLUS KOPACKI, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
200 JEFFERSON AVE SE
GRAND RAPIDS, MI
ZIP 49503
Phone: (800) 968-6866
Get Directions

Nicholus Kopacki, PA is a medical physician assistant in Grand Rapids, MI. Nicholus Kopacki, PA NPI is 1417112004. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

200 JEFFERSON AVE SE
GRAND RAPIDS, MI
ZIP 49503-502
Phone: (800) 968-6866

The enumeration date for this NPI number is 7/23/2008 and was last updated on 7/23/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	5601005277	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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