Healthcare Provider Details

I. General information

NPI: 1003463381
Provider Name (Legal Business Name): EMILY LINCOLN RN, NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2019
Last Update Date: 04/26/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PL
SAINT LOUIS MO
63110-1081
US

IV. Provider business mailing address

1 CHILDRENS PL
SAINT LOUIS MO
63110-1081
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-6000
  • Fax:
Mailing address:
  • Phone: 314-454-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number2019029262
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: