Provider Demographics
NPI:1508954777
Name:LINCKS, LINDY A (RN, ANP, NP)
Entity Type:Individual
Prefix:
First Name:LINDY
Middle Name:A
Last Name:LINCKS
Suffix:
Gender:F
Credentials:RN, ANP, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5414 FM 180
Mailing Address - Street 2:
Mailing Address - City:LEDBETTER
Mailing Address - State:TX
Mailing Address - Zip Code:78946-7066
Mailing Address - Country:US
Mailing Address - Phone:979-803-0185
Mailing Address - Fax:833-970-0942
Practice Address - Street 1:5414 FM 180
Practice Address - Street 2:
Practice Address - City:LEDBETTER
Practice Address - State:TX
Practice Address - Zip Code:78946-7066
Practice Address - Country:US
Practice Address - Phone:832-317-1651
Practice Address - Fax:833-970-0942
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX582602363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
O45804Medicare UPIN
8D6011Medicare ID - Type Unspecified