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

Jaclyn Nicole Churchill

Individual provider Physician Assistant · NPI 1568695807

Jaclyn Nicole Churchill is a Physician Assistant in New York, New York. Licensed in Florida. Registered with an NPI since 2009.

Licensed in
FL
In the registry since
2009

Practice location Address checks out

200 W 58th St
New York, NY 10019-1476
Phone: (212) 757-7010
Fax: (212) 307-0759
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA 9104938 (FL)

Record details

NPI number1568695807
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 3, 2009
Last updated in NPPESFebruary 2, 2023
Certification dateFebruary 2, 2023

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