National Provider Identifier

Jacqueline Nicole Palmer, MCMSC, PA-C

Jacqueline Nicole Palmer, MCMSC, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Newark, NY and a listed phone number of (315) 359-2696.

NPI 1194470021Newark, NYPhysician Assistant

Profile Overview

NPI
1194470021
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
February 18, 2022
Last Updated
February 18, 2022

Practice Location

  • 1200 Driving Park Ave Ste 4
  • Newark, NY 14513-1090

Phone: (315) 359-2696

Mailing Address

  • 40 N Shore Blvd Apt 217
  • Canandaigua, NY 14424-2389

Specialties

  • Physician Assistant (363A00000X)
  • Physician Assistant (363A00000X)
Full Record
NPI
1194470021
Entity Type
Individual
Last Name
Palmer
First Name
Jacqueline
Middle Name
Nicole
Name Prefix
Miss
Credential
MCMSC, PA-C
Mailing Street Address
40 N Shore Blvd Apt 217
Mailing City
Canandaigua
Mailing State
NY
Mailing ZIP Code
14424-2389
Mailing Country
US
Mailing Phone
(440) 539-5993
Practice Street Address
1200 Driving Park Ave Ste 4
Practice City
Newark
Practice State
NY
Practice ZIP Code
14513-1090
Practice Country
US
Practice Phone
(315) 359-2696
Practice Fax
(315) 359-2699
Enumeration Date
February 18, 2022
Last Updated
February 18, 2022
Sex
Female
Sole Proprietor
No
Certification Date
February 18, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X), Physician Assistant (363A00000X)