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

Nicole J Charles, PAC

Individual provider Medical Physician Assistant · NPI 1104008093

Nicole J Charles, PAC is a Physician Assistant in Waconia, Minnesota. Qualified in 2007, 19 years ago. Practices with Ridgeview Medical Center, a 406-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
19
Licensed in
MN
In the registry since
2007
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

See every abbreviation used in this directory →

Practice location Address checks out

500 S Maple St
Waconia, MN 55387-1752
Phone: (952) 442-2191
Fax: (952) 974-3201
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 1081 (MN)

Record details

NPI number1104008093
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedDecember 3, 2007
Last updated in NPPESMarch 23, 2021
Certification dateMarch 23, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Ridgeview Medical Center — 406 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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