Provider Demographics
NPI:1083805410
Name:LINCOLN, MICHELLE THERESA (NP)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:THERESA
Last Name:LINCOLN
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Gender:
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:246 PLEASANT ST.
Mailing Address - Street 2:MEMORIAL BUILDING, WEST, GROUND FLOOR
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301
Mailing Address - Country:US
Mailing Address - Phone:603-224-9661
Mailing Address - Fax:603-227-7528
Practice Address - Street 1:246 PLEASANT ST.
Practice Address - Street 2:MEMORIAL BUILDING, WEST, GROUND FLOOR
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-224-9661
Practice Address - Fax:603-227-7528
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RINPP37593363LF0000X
MA242445363LF0000X
NH034118-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1022303Medicaid
NH3089974Medicaid