Provider Demographics
NPI:1912682956
Name:HALEY, JAYDA (CNM/WHNP)
Entity Type:Individual
Prefix:MRS
First Name:JAYDA
Middle Name:
Last Name:HALEY
Suffix:
Gender:F
Credentials:CNM/WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 MARTIN LN
Mailing Address - Street 2:
Mailing Address - City:COTTONTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37048-4616
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:400 W 16TH ST
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2745
Practice Address - Country:US
Practice Address - Phone:719-595-7471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0100703367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife