| NPI | 1063990273 |
|---|---|
| Former Name | JAYLA BREANN MIDDLETON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.030975) |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2025-04-10 |