Provider Demographics
NPI:1043559610
Name:LOCKHART-PHILIP, DONNA (CNM)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:LOCKHART-PHILIP
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:LOCKHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:4007 DIAMOND RUBY
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820
Mailing Address - Country:US
Mailing Address - Phone:340-772-7349
Mailing Address - Fax:340-772-7427
Practice Address - Street 1:4007 DIAMOND RUBY
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820
Practice Address - Country:US
Practice Address - Phone:340-772-7349
Practice Address - Fax:340-772-7427
Is Sole Proprietor?:No
Enumeration Date:2013-02-02
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VIAP9423367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife