Provider Demographics
NPI:1881686996
Name:LINCOLN, JANET MARIE (FNP)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:MARIE
Last Name:LINCOLN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:JANET
Other - Middle Name:MARIE
Other - Last Name:GALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:8 PILGRIM HILL RD
Mailing Address - Street 2:MINUTECLINIC /TARGET PRIMARY PRACTICE
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-6123
Mailing Address - Country:US
Mailing Address - Phone:866-389-2727
Mailing Address - Fax:401-652-9787
Practice Address - Street 1:8 PILGRIM HILL RD
Practice Address - Street 2:MINUTECLINIC/TARGET PRIMARY PRACTICE 8 PILGRIM HILL RD
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-6123
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:401-652-9787
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA123913363L00000X, 363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0316962Medicaid
NP3900OtherBCBS
NP3900OtherBCBS
MA0316962Medicaid