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

Molly Nichols

Individual provider Physician Assistant · NPI 1083154470

Molly Nichols is a Physician Assistant in Boise, Idaho. Qualified in 2018, 8 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho and Oregon.

Years since qualifying
8
Licensed in
ID, OR
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

12080 W McMillan Rd
Boise, ID 83713-2462
Phone: (208) 375-4955
Fax: (208) 375-5568
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1501 Ne Medical Center Dr, Bend, OR 97701-6051 — (541) 382-4900

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 996162 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA189595 (OR)

Record details

NPI number1083154470
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 3, 2017
Last updated in NPPESSeptember 10, 2024
Certification dateSeptember 10, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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