# ALISHA BREANNA JAIN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1942718978
- **Gender:** F
- **Credential:** PMHNP-BC; APRN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2018001757 | MO | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 2018001757 | MO | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 213500 | AR | — |

## Other

- **Enumeration date:** 01/11/2018
- **Last updated:** 04/17/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 259139758 | — | AR |
| 05 | — | 420050654 | — | MO |