Provider Demographics
NPI:1275377095
Name:LINCKE, CHRISTA (FNP-C)
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:LINCKE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CHRISTA
Other - Middle Name:
Other - Last Name:LINCKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, APRN, FNP-C
Mailing Address - Street 1:3219 KNAPE RD
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:TX
Mailing Address - Zip Code:78945-2382
Mailing Address - Country:US
Mailing Address - Phone:512-431-6201
Mailing Address - Fax:
Practice Address - Street 1:372 HILL RD
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:TX
Practice Address - Zip Code:78957-8431
Practice Address - Country:US
Practice Address - Phone:512-237-4606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1167640363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily