Individual provider · NPI-1

Nicklaus Brian Childers, NP-C

Nurse Practitioner, Family · Columbus, GA

NPI number1093036725
StatusActive
Last updated in NPPESOct 28, 2025

Details

NPI
1093036725
Entity type
Individual (NPI-1)
Name
Nicklaus Brian Childers
Credential
NP-C
Sex
Male
Sole proprietor
No
Enumeration date
Jun 16, 2010
Certification date
Oct 28, 2025
Last updated
Oct 28, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, FamilyAPRN-NP176292GAYes
363LF0000X Nurse Practitioner, Family1-116752AL
163WR0006X Registered Nurse, Registered Nurse First AssistantRN176292GA
163WR0006X Registered Nurse, Registered Nurse First Assistant1-116752AL

Practice location

6262 Veterans Pkwy
Columbus, GA 31909

Phone 706-324-6661 · Fax 706-494-3235

Mailing address

Po Box 370
Fortson, GA 31808-0370

Fax 706-494-3008

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