National Provider Identifier
Jacquelyn Peterson
Jacquelyn Peterson is listed in the NPPES registry with a primary specialty of Medical Physician Assistant in Jamestown, NY and a listed phone number of (716) 753-7107.
Profile Overview
- NPI
- 1124019948
- Provider Type
- Individual
- Primary Specialty
- Medical Physician Assistant
- Enumeration Date
- November 01, 2005
- Last Updated
- June 15, 2021
Practice Location
- 320 Prather Ave
- Jamestown, NY 14701-6820
Phone: (716) 753-7107
Mailing Address
- 95 E Chautauqua St
- PO Box 168
- Mayville, NY 14757-1017
Specialties
- Medical Physician Assistant (363AM0700X)
Endpoints
- upmchospitals@upmcdirect.com
Direct Messaging Address | Upmc | Pittsburgh, PA 15219
Full Record
- NPI
- 1124019948
- Entity Type
- Individual
- Last Name
- Peterson
- First Name
- Jacquelyn
- Mailing Street Address
- 95 E Chautauqua St
- Mailing Address Line 2
- PO Box 168
- Mailing City
- Mayville
- Mailing State
- NY
- Mailing ZIP Code
- 14757-1017
- Mailing Country
- US
- Practice Street Address
- 320 Prather Ave
- Practice City
- Jamestown
- Practice State
- NY
- Practice ZIP Code
- 14701-6820
- Practice Country
- US
- Practice Phone
- (716) 753-7107
- Enumeration Date
- November 01, 2005
- Last Updated
- June 15, 2021
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- May 13, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Medical Physician Assistant (363AM0700X)