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

Jacquelyn Peterson

Individual provider Medical Physician Assistant · NPI 1124019948

Jacquelyn Peterson is a Medical Physician Assistant in Jamestown, New York. Licensed in New York. Registered with an NPI since 2005.

Licensed in
NY
In the registry since
2005

Practice location Address checks out

320 Prather Ave
Jamestown, NY 14701-6820
Phone: (716) 753-7107
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 007012 (NY)

Record details

NPI number1124019948
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 1, 2005
Last updated in NPPESJune 15, 2021
Certification dateMay 13, 2021
Mailing address95 E Chautauqua St, Po Box 168, Mayville, NY 14757-1017

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