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

Jaclyn Park

Individual provider Physician Assistant · NPI 1851783708

Jaclyn Park is a Physician Assistant in Roanoke, Virginia. Licensed in Virginia. Registered with an NPI since 2015.

Licensed in
VA
In the registry since
2015
Specialties on file
2

Practice location Address checks out

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone: (540) 981-7000
Fax: (540) 985-6920
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0110004841 (VA)
Physician Assistant Taxonomy 363A00000X · Licence 0110-004841 (VA)

Record details

NPI number1851783708
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 2, 2015
Last updated in NPPESOctober 17, 2025
Certification dateOctober 17, 2025
Mailing address213 S Jefferson St Ste 1006, Roanoke, VA 24011-1713

Other providers in Roanoke