Nicholson, Jeffrey Gerard

Nicholson, Jeffrey Gerard is an sole proprietor health care provider with primary practice located at 19035 W Capitol Dr Suite 101, Brookfield WI 53045-2755. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Nicholson, Jeffrey Gerard can be contacted via phone (262) 754-1421.

Contact Information

Primary practice address
19035 W Capitol Dr Suite 101 Brookfield WI 53045-2755
Fax: (262) 754-3760
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 904-023 Wisconsin

Profile Details

NPI number 1326018904
LBN Legal business name Nicholson, Jeffrey Gerard
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 25th, 2006
Last updated Aug 17th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326018904 NPPES
Wisconsin MEDICAID 42981400
Wisconsin Other WI1826001

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