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

Kenzie Ann Nichols

Individual provider Physician Assistant · NPI 1417642687

Kenzie Ann Nichols is a Physician Assistant in Pine Bluffs, Wyoming. Qualified in 2023, 3 years ago. Practices with Cheyenne Regional Physicians Group LLC, a 103-clinician group and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2023
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Practice location Address checks out

830 Sanders Dr
Pine Bluffs, WY 82082-9755
Phone: (307) 575-7835
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1417642687
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 5, 2023
Last updated in NPPESOctober 17, 2025
Certification dateOctober 17, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Cheyenne Regional Physicians Group Llc — 103 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Cheyenne Regional Physicians Group LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 103 clinicians in the practice; 12 are shown here.