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

Nicole Renee Prosser, PA-C

Individual provider Physician Assistant · NPI 1780635003

Nicole Renee Prosser, PA-C is a Physician Assistant in Zimmerman, Minnesota. Qualified in 2000, 26 years ago. Practices with Fairview Clinics, a 806-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
26
Licensed in
MN
In the registry since
2006
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

25945 Gateway Dr
Zimmerman, MN 55398-5300
Phone: (763) 856-6900
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9576 (MN)

Record details

NPI number1780635003
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 12, 2006
Last updated in NPPESMay 19, 2008

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Fairview Clinics — 806 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations9 on file with Medicare

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