Provider Demographics
NPI:1326629775
Name:LINCOLN, ALEXIS ROSANNE (NP)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:ROSANNE
Last Name:LINCOLN
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Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4550 E BELL RD STE 170
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-9385
Mailing Address - Country:US
Mailing Address - Phone:480-443-8400
Mailing Address - Fax:480-433-8697
Practice Address - Street 1:9520 W PALM LN STE 220
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-4403
Practice Address - Country:US
Practice Address - Phone:480-443-8400
Practice Address - Fax:480-443-8697
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-17
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ290314363LG0600X, 163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No163WG0600XNursing Service ProvidersRegistered NurseGerontologyGroup - Multi-Specialty