Provider Demographics
NPI:1205123544
Name:LINCOLN, JAIME L (CPNP, RN)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:L
Last Name:LINCOLN
Suffix:
Gender:F
Credentials:CPNP, RN
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:L
Other - Last Name:IPPOLITO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1029 PLEASANT ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02324
Mailing Address - Country:US
Mailing Address - Phone:508-697-8116
Mailing Address - Fax:508-697-8117
Practice Address - Street 1:1029 PLEASANT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324
Practice Address - Country:US
Practice Address - Phone:508-697-8116
Practice Address - Fax:508-697-8117
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2264130363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics