Nicole Bodner, PA
Individual provider Active NPI Physician Assistant · Wingate, NC
NPI 1043149016 · NPPES record last updated May 15, 2026
Key facts
- NPI
- 1043149016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 515 N Main St
Wingate, NC 28174-8274 - Phone
- (704) 233-8331
- NPI assigned
- May 15, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Physician Assistant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
515 N Main St
Wingate, NC 28174-8274
Mailing address
515 N Main St
Wingate, NC 28174-8274
Other providers in Wingate, NC
- Emma Acree
- Erica Anderson
- Annasus Companion Care LLC
- Payton Makayla Austin
- Jessica Barbier
- Adriane J Brackett
- Olivia Brown
- Ara Caroline Burger
- Danielle Burningham
- Leigh Ann Caldwell
All providers in Wingate, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.