Individual
DR. CHARISSA NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 456-5537
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 456-5537
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1699417170
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2022
Last updated
04/15/2026
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