Provider Demographics
NPI:1972234581
Name:LINCOLN, LISA (NP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:LINCOLN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:171 MAIN ST STE 203B
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-1187
Mailing Address - Country:US
Mailing Address - Phone:508-881-3029
Mailing Address - Fax:508-881-1752
Practice Address - Street 1:29 HUDSON RD STE 3310
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-1753
Practice Address - Country:US
Practice Address - Phone:978-443-8810
Practice Address - Fax:978-443-8839
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2023-10-30
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Provider Licenses
StateLicense IDTaxonomies
MARN2308374363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110192529AMedicaid