Jake Anthony Nicholson, DO is a vascular surgery surgery in Grand Rapids, MI. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. Jake Anthony Nicholson, DO NPI is 1467013698. 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:
100 MICHIGAN ST NE STE A501
GRAND RAPIDS, MI
ZIP 49503-560
Phone: (616) 391-0056
The NPI 1467013698 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 6/27/2019 and was last updated on 5/26/2022.