Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACLYN PARK
ActiveJACLYN PARK is a Physician Assistant healthcare provider located in ROANOKE, Virginia. NPI 1851783708 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · ROANOKE, VA
Registration Details
- NPI Number
- 1851783708
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 2, 2015 (11.471549385613 yrs)
- Last Updated
- Oct 17, 2025
- Licenses
-
0110-004841 (VA)0110004841 (VA)
Practice Information
- Address
-
1906 BELLEVIEW AVE SEROANOKE, VA, 240141838Browse VA providers · Browse ZIP 24014
- Phone
- 5409817000
- Fax
- 5409856920
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in ROANOKE, VA
| Name | Credential | NPI |
|---|---|---|
| CLYDE W WOODYARD | PA-C | 1720083785 |
| PAMELA LAPRADE | PA-C | 1326047564 |
| JOSEPH RANDOLPH HOWELL | PA-C | 1649271461 |
| LAUREN E GOATER-MATHIS | PA-C | 1235130519 |
| AMY J OSTERMANN | PA-C | 1912980491 |
| MR. JOSEPH BUCKNER EDDINS III | PA | 1285611269 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.