Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Broc Nichelson

Individual provider Certified Registered Nurse Anesthetist · NPI 1154711497

Broc Nichelson is a Certified Registered Nurse Anesthetist (CRNA) in Toledo, Ohio. Qualified in 2014, 12 years ago. Practices with Promedica Central Physicians, a 784-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
12
Licensed in
OH
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

2142 N Cove Blvd
Toledo, OH 43606-3895
Phone: (419) 291-4491
Fax: (419) 479-6905
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence APRN.CRNA.16984 (OH)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 16984-NA (OH)

Record details

NPI number1154711497
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 26, 2015
Last updated in NPPESApril 5, 2021
Certification dateApril 5, 2021
Mailing address333 N Summit St Fl 7, Toledo, OH 43604-1531

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Promedica Central Physicians — 784 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Toledo