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General NPI Number Information
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NPI Number | 1154608479
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Entity Type | Individual
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Provider Name | LINCY MATHEW RNFA, CNOR
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Gender | Female
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Dates
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Enumeration Date | 11/15/2011
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Last Update Date | 01/13/2015
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Provider Practice Location Address
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Address Line | 1301 MERCY CT
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City | GARLAND
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State | TX
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Zip | 75043-1762
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Country | US
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Telephone | 214-703-0226
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 MERCY CT
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City | GARLAND
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State | TX
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Zip | 75043-1762
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Country | US
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Telephone | 214-703-0226
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 732937
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License Number State | TX
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