Individual
MILDRED LINCOLN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
516 EAST NIZHONI BLVD, GALLUP, NM 87301
(505) 722-1282
(505) 722-1525
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1282
(505) 722-1525
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-0658
NM
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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