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

Nicole Warner, PA

Individual provider Physician Assistant · NPI 1114544525

Nicole Warner, PA is a Physician Assistant in Atlanta, Georgia. Qualified in 2020, 6 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
6
Licensed in
GA
In the registry since
2020
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

1100 Johnson Fy Rd NE Ste 180
Atlanta, GA 30342-1795
Phone: (404) 250-6691
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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 9903 (GA)

Record details

NPI number1114544525
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 1, 2020
Last updated in NPPESNovember 21, 2023
Certification dateNovember 21, 2023
Mailing address1100 Johnson Fy Rd Ne Ste 180, Atlanta, GA 30342-1795

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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