1376866673 NPI number — STEPHEN JEFFREY LINCK RN, MSN

Table of content: STEPHEN JEFFREY LINCK RN, MSN (NPI 1376866673)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376866673 NPI number — STEPHEN JEFFREY LINCK RN, MSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LINCK
Provider First Name:
STEPHEN
Provider Middle Name:
JEFFREY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN, MSN
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376866673
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CMR 411, BLDG 700, ROSE BARRACKS
Provider Second Line Business Mailing Address:
USA MEDDAC BAVARIA
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
499662834719
Provider Business Mailing Address Fax Number:
499662834721

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CMR 411, BLDG 700, ROSE BARRACKS
Provider Second Line Business Practice Location Address:
USA MEDDAC BAVARIA
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AE
Provider Business Practice Location Address Postal Code:
09112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
499662834719
Provider Business Practice Location Address Fax Number:
499662834721
Provider Enumeration Date:
03/02/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WA2000X , with the licence number:  073221 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 163WC0200X , with the licence number: 649473 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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