Provider Demographics
NPI:1306453014
Name:JONES, ALISHA MICHELLE (FNP-C)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:MICHELLE
Last Name:JONES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:HEALTH
Other - Middle Name:OPTIMIZATION
Other - Last Name:TREATMENT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LLC
Mailing Address - Street 1:8 LAURELWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4940
Mailing Address - Country:US
Mailing Address - Phone:309-592-2639
Mailing Address - Fax:
Practice Address - Street 1:205 W 11TH ST
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-2804
Practice Address - Country:US
Practice Address - Phone:314-279-4565
Practice Address - Fax:309-326-4526
Is Sole Proprietor?:No
Enumeration Date:2020-09-26
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOF12190552363LF0000X
MO2021035418363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily