National Provider Identifier
Mary Jill Vaillancourt, CRNP
Mary Jill Vaillancourt, CRNP is listed in the NPPES registry with a primary specialty of Adult Health Nurse Practitioner in Jamestown, NY and a listed phone number of (716) 484-4334.
Profile Overview
- NPI
- 1104290915
- Provider Type
- Individual
- Primary Specialty
- Adult Health Nurse Practitioner
- Enumeration Date
- November 17, 2015
- Last Updated
- August 31, 2023
Practice Location
- 107 Institute St
- Jamestown, NY 14701-6628
Phone: (716) 484-4334
Specialties
- Adult Health Nurse Practitioner (363LA2200X)
- Adult Health Nurse Practitioner (363LA2200X)
- Gerontology Nurse Practitioner (363LG0600X)
- Nurse Practitioner (363L00000X)
- Registered Nurse (163W00000X)
Full Record
- NPI
- 1104290915
- Entity Type
- Individual
- Last Name
- Vaillancourt
- First Name
- Mary
- Middle Name
- Jill
- Credential
- CRNP
- Mailing Street Address
- 107 Institute St
- Mailing City
- Jamestown
- Mailing State
- NY
- Mailing ZIP Code
- 14701-6628
- Mailing Country
- US
- Mailing Phone
- (716) 484-4334
- Mailing Fax
- (833) 974-2029
- Practice Street Address
- 107 Institute St
- Practice City
- Jamestown
- Practice State
- NY
- Practice ZIP Code
- 14701-6628
- Practice Country
- US
- Practice Phone
- (716) 484-4334
- Practice Fax
- (833) 974-2029
- Enumeration Date
- November 17, 2015
- Last Updated
- August 31, 2023
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- August 31, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Adult Health Nurse Practitioner (363LA2200X), Adult Health Nurse Practitioner (363LA2200X), Gerontology Nurse Practitioner (363LG0600X), Nurse Practitioner (363L00000X), Registered Nurse (163W00000X)