Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Brenda J Nichols, PA-C

Individual provider Physician Assistant · NPI 1558426882

MS. Brenda J Nichols, PA-C is a Physician Assistant in Grand Rapids, Michigan. Licensed in Illinois, Michigan and Wisconsin. Registered with an NPI since 2006.

Licensed in
IL, MI, WI
In the registry since
2006
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1111 Leffingwell Ave NE
Grand Rapids, MI 49525-6406
Phone: (616) 459-7101
Fax: (616) 464-6170
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5601006279 (MI)
Physician Assistant Taxonomy 363A00000X · Licence 085-002520 (IL)
Physician Assistant Taxonomy 363A00000X · Licence 2100 (WI)

Record details

NPI number1558426882
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 27, 2006
Last updated in NPPESMay 13, 2022
Certification dateMay 13, 2022

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