Individual
MR. NICHOLAS PATRICK CALLAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, CRNA
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 685-5000
Mailing address
7817 SCHOOLSIDE DR, HUDSONVILLE, MI 49426-8653
(616) 550-5506
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704303499
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704303499NSA2006D
MI
Other
Enumeration date
04/20/2020
Last updated
10/26/2020
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