| NPI | 1497128029 |
|---|---|
| Former Name | GRACE SIMONE LOCKLUND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP129359) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 823154) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2023-03-13 |