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

Mrs. Nicole M Boudreaux, PA-C

Individual provider Medical Physician Assistant · NPI 1699231894

Mrs. Nicole M Boudreaux, PA-C is a Physician Assistant in Princess Anne, Maryland. Qualified in 2018, 8 years ago. Practices with Lower Shore Immediate Care LLC, a 6-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
8
Licensed in
MD
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

12302 Somerset Ave Ste AB
Princess Anne, MD 21853-3099
Phone: (410) 651-0300
Show map & directions

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

Additional practice locations (1)

  • 205 S Division St, Salisbury, MD 21801-4930 — (443) 944-9896

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence C0007122 (MD)
Emergency Medicine Physician Taxonomy 207P00000X · Licence C0007122 (MD)

Record details

NPI number1699231894
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 13, 2019
Last updated in NPPESDecember 27, 2023
Certification dateDecember 27, 2023

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 Lower Shore Immediate Care Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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