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

Mary Jill Vaillancourt, CRNP

Individual provider Nurse Practitioner · NPI 1104290915

Mary Jill Vaillancourt, CRNP is a Nurse Practitioner in Jamestown, New York. Licensed in New York and Pennsylvania. Registered with an NPI since 2015.

Licensed in
NY, PA
In the registry since
2015
Specialties on file
6
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

107 Institute St
Jamestown, NY 14701-6628
Phone: (716) 484-4334
Fax: (833) 974-2029
Show map & directions

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

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence F307302 (NY)
Nurse Practitioner Taxonomy 363L00000X · Licence SP015710 (PA)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence SP015710 (PA)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence SP015710 (PA)
Registered Nurse Taxonomy 163W00000X · Licence RN578441 (PA)
Registered Nurse Taxonomy 163W00000X · Licence 362456 (NY)

Record details

NPI number1104290915
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorNo
NPI enumeratedNovember 17, 2015
Last updated in NPPESAugust 31, 2023
Certification dateAugust 31, 2023

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