MEDICARE: NICHOLAS GRANT COLLINS DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	3171759	ID

General Provider Information

NPI Number	:	1548889025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLAS GRANT COLLINS DO

Provider Business Mailing Address
First Line	:	1201 LARIMER ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-2007
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 LARIMER ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-2007
Country	:	US
Telephone Number	:	303-724-3483
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2020
Last Update Date	:	08/04/2025

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