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Individual

MS. AMEENA JAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1012 S NORTH POINT RD, BALTIMORE, MD 21224-3338
(443) 216-4800
Mailing address
1012 S NORTH POINT RD, BALTIMORE, MD 21224-3338
(443) 216-4800

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
764950
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R211311
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
306307501
TX
Enumeration date
09/05/2012
Last updated
04/25/2017
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