Pride, Lance Lincoln

Pride, Lance Lincoln is an individual health care provider with primary practice located at 601 John St Ste M-460 , Kalamazoo MI 49007-5355. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Pride, Lance Lincoln can be contacted via phone (269) 341-7333.

Contact Information

Primary practice address
601 John St Ste M-460 Kalamazoo MI 49007-5355
Fax: (269) 341-7371
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 5601006118 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 5601006118 Michigan

Profile Details

NPI number 1437432036
LBN Legal business name Pride, Lance Lincoln
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2011
Last updated Nov 27th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437432036 NPPES
Virginia Other VV9406A MEDICARE PTAN
Virginia MEDICAID 14374322036 MEDICARE PTAN
Virginia Other 10111084P MEDICARE PTAN
Virginia Other 14374322036 MEDICARE PTAN

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