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

Guinevere M Nilles, PA

Individual provider Physician Assistant · NPI 1265819064

Guinevere M Nilles, PA is a Physician Assistant in Fort Wayne, Indiana. Licensed in Indiana. Registered with an NPI since 2015.

Licensed in
IN
In the registry since
2015
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

7910 W Jefferson Blvd Ste 108
Fort Wayne, IN 46804-4159
Phone: (260) 484-8830
Fax: (260) 483-1911
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10001910A (IN)
Physician Assistant Taxonomy 363A00000X (IN)

Record details

NPI number1265819064
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 30, 2015
Last updated in NPPESJuly 23, 2020
Certification dateJuly 23, 2020

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