Healthcare Provider Details

I. General information

NPI: 1942841606
Provider Name (Legal Business Name): LINDSIE MICHELLE LINCOLN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2019
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9850 W ST LUKES DR # 221
NAMPA ID
83687-7912
US

IV. Provider business mailing address

9850 W ST LUKES DR # 221
NAMPA ID
83687-7912
US

V. Phone/Fax

Practice location:
  • Phone: 208-593-6340
  • Fax: 208-593-6341
Mailing address:
  • Phone: 208-593-6340
  • Fax: 208-593-6341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number201908866NP-PP
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number3581310
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: