Provider Demographics
NPI:1376866673
Name:LINCK, STEPHEN JEFFREY (RN, MSN)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JEFFREY
Last Name:LINCK
Suffix:
Gender:M
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 411, BLDG 700, ROSE BARRACKS
Mailing Address - Street 2:USA MEDDAC BAVARIA
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09112
Mailing Address - Country:US
Mailing Address - Phone:49966-283-4719
Mailing Address - Fax:49966-283-4721
Practice Address - Street 1:CMR 411, BLDG 700, ROSE BARRACKS
Practice Address - Street 2:USA MEDDAC BAVARIA
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09112
Practice Address - Country:US
Practice Address - Phone:49966-283-4719
Practice Address - Fax:49966-283-4721
Is Sole Proprietor?:No
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ073221163WA2000X
TX649473163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADOOMedicare UPIN