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

Mrs. Nicholette Brosseau

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1720639263

Mrs. Nicholette Brosseau is a Physician Assistant in Wagoner, Oklahoma. Qualified in 2020, 6 years ago. Practices with Creek Nation Hospital and Clinics, a 390-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
6
In the registry since
2019
Specialties on file
2

Practice location Address checks out

1520 SW 1st St
Wagoner, OK 74467-4839
Phone: (918) 704-7825
Show map & directions

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

Additional practice locations (1)

  • 5130 S Hudson Pl, Tulsa, OK 74135-7509 — (918) 704-7825

Specialties & licences

Urgent Care Clinic/Center (primary) Taxonomy 261QU0200X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1720639263
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 25, 2019
Last updated in NPPESNovember 9, 2020
Certification dateNovember 9, 2020
Mailing address5130 S Hudson Pl, Tulsa, OK 74135-7509

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Creek Nation Hospital And Clinics — 390 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Wagoner