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

Nichole Susanna Fortin, PA

Individual provider Physician Assistant · NPI 1558668210

Nichole Susanna Fortin, PA is a Physician Assistant in Greenville, South Carolina. Licensed in South Carolina. Registered with an NPI since 2011.

Licensed in
SC
In the registry since
2011
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

701 Grove Rd Fl 5
Greenville, SC 29605-4210
Phone: (864) 455-4411
Fax: (864) 455-4480
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2267 (SC)

Record details

NPI number1558668210
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 16, 2011
Last updated in NPPESApril 24, 2015

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