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Contact Information

GRANT S NICHOLS III, PA-C
2685 DUBLIN BLVD
COLORADO SPRINGS, CO80918-1358
 Phone: 719-592-9890
 Fax: 719-264-7908
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Electroneurodiagnostic

246ZE0600X
Indicates primary specialty

NPI Profile & details for GRANT S NICHOLS III · (Male)

NPI Number 1891051223
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 04/10/2012
Last updated 12/30/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • CO License # PA.0004492
Hospital affiliation(s)
  • CENTURA HEALTH-ST MARY CORWIN MEDICAL CENTER - (Acute Care)
    1008 MINNEQUA AVE
    PUEBLO, CO 81004
  • PARKVIEW MEDICAL CENTER INC - (Acute Care)
    400 W 16TH STREET
    PUEBLO, CO 81003
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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