Healthcare Provider Details

I. General information

NPI: 1447178892
Provider Name (Legal Business Name): NICHOLAS ELGERT JR. RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 E KEARSLEY ST
FLINT MI
48502-1907
US

IV. Provider business mailing address

163 RIVERSIDE DR
MOUNT CLEMENS MI
48043-2541
US

V. Phone/Fax

Practice location:
  • Phone: 810-762-3147
  • Fax:
Mailing address:
  • Phone: 586-764-8457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: