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

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

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