| NPI | 1366874273 |
|---|---|
| Former Name | STEPHANIE LOCKETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: IN 71004654A) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28162213A) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IN 71004654A) | |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2022-07-21 |