MEDICARE: SUSAN MERYL LINCOLN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0808X	Psychiatric/Mental Health Registered Nurse	20617	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851371603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN MERYL LINCOLN RN

Provider Business Mailing Address
First Line	:	71 B READ AVENUE
Second Line	:
City	:	LINCOLN
State	:	RI
Zip	:	02865-2615
Country	:	US
Telephone Number	:	401-726-4745
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 OLD COUNTY ROAD
Second Line	:
City	:	BARRINGTON
State	:	RI
Zip	:	02886-1506
Country	:	US
Telephone Number	:	401-246-1195
Fax Number	:	401-246-3078

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	07/08/2007

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