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General NPI Number Information
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NPI Number | 1083669402
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Entity Type | Individual
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Provider Name | NICHOLA K JARDAS PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 26 E SAGINAW RD UNIT 4
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City | SANFORD
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State | MI
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Zip | 48657-9293
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Country | US
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Telephone | 989-687-7812
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Fax | 989-687-7813
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Provider Business Mailing Address
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Address Line | 315 E WARWICK DR STE 3
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City | ALMA
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State | MI
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Zip | 48801-1083
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Country | US
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Telephone | 899-463-6699
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Fax | 989-466-2574
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601004596
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License Number State | MI
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