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General NPI Number Information
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NPI Number | 1518480862
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Entity Type | Individual
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Provider Name | NICHOLAS JOHN NAAYERS
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Gender | Male
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 2 EMBARCADERO CTR LBBY LEVEL
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City | SAN FRANCISCO
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State | CA
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Zip | 94111-3823
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Country | US
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Telephone | 888-663-6331
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Fax | 415-252-7176
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Provider Business Mailing Address
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Address Line | 6001 DREXEL LN APT 1319
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City | FORT MYERS
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State | FL
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Zip | 33919-5222
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Country | US
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Telephone | 419-410-7324
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Fax |
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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 | PA63323
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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