Individual
DANIEL NATHAN NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2500 METROHEALTH DR, CLEVELAND, OH 44109-1900
(216) 778-7800
Mailing address
2500 METROHEALTH DR, CLEVELAND, OH 44109-1900
(216) 778-7800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
015383-1
NY
363A00000X
Physician Assistant
2271845
ID
363A00000X
Physician Assistant
PA9119112
FL
363AS0400X
Surgical Physician Assistant
015383-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000534102001
BCBS OF WNY
NY
01
—
1043595911
UNIVERA
NY
01
—
120326000119
FIDELIS
NY
01
—
9516980
INDEPENDENT HEALTH ASSOCIATION
NY
Enumeration date
10/11/2011
Last updated
02/06/2025
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