Mrs. Nicole Marie Kiesow, PA-C
Mrs. Nicole Marie Kiesow, PA-C is a Physician Assistant in Fosston, Minnesota. Qualified in 2008, 18 years ago. Practices with Headwaters Health PC, a 10-clinician group and accepts Medicare assignment.
- Years since qualifying
- 18
- In the registry since
- 2008
What do these letters mean?
- PA-C — Physician Assistant, Certified
- A physician assistant who holds current national certification.
Practice location Address checks out
111 2nd St NEFosston, MN 56542-1301
Phone: (218) 435-1111
Fax: (218) 435-1112
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X |
|---|
Record details
| NPI number | 1356502769 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | PA-C |
| Sole proprietor | No |
| NPI enumerated | June 18, 2008 |
| Last updated in NPPES | April 24, 2026 |
| Certification date | April 24, 2026 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2008 (18 years in practice) |
| Group practice | Headwaters Health Pc — 10 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 4 on file with Medicare |
Other providers in Fosston
-
Corinne A Dargus, PAC
102 Sather Dr, Fosston, MN 56542-1531 · (218) 435-1212
-
Bryan Mikael Johnson, PA-C
111 2nd St NE, Fosston, MN 56542-1301 · (218) 435-1111