Individual provider · Type 1 NPI

Jacquelyn Peterson

Medical Physician Assistant · Jamestown, NY

NPI number 1124019948 Active

Practice location

320 Prather Ave
Jamestown, NY 14701-6820

Mailing address

95 E Chautauqua St, PO Box 168
Mayville, NY 14757-1017

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X007012 (NY)

Medical Physician Assistant: Definition to come...

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About NPI 1124019948

Jacquelyn Peterson's National Provider Identifier is 1124019948, issued on Nov 1, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Jamestown, NY. The record was last updated on Jun 15, 2021.