Individual provider · Type 1 NPI

Nicole Marie Kiesow, PA-C

Physician Assistant · Fosston, MN

NPI number 1356502769 Active

Practice location

111 2nd St NE
Fosston, MN 56542-1301

Fax (218) 435-1112

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XNone listed

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1356502769

Nicole Marie Kiesow, PA-C's National Provider Identifier is 1356502769, issued on Jun 18, 2008. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Fosston, MN. The record was last updated on Apr 24, 2026.