Individual
MS. JESSICA ANNE MIDDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1882
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1882
SC LICENSE
SC
05
—
2452PA
—
SC
Enumeration date
07/19/2011
Last updated
01/30/2025
Update your record
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