Provider Demographics
NPI:1205027315
Name:LOCKWOOD, JULIE ELLEN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ELLEN
Last Name:LOCKWOOD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:JJULIE
Other - Middle Name:E
Other - Last Name:RINDFLEISCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 308
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-1806
Mailing Address - Country:US
Mailing Address - Phone:480-718-5400
Mailing Address - Fax:877-666-4624
Practice Address - Street 1:8360 E RAINTREE DR STE 105
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2677
Practice Address - Country:US
Practice Address - Phone:480-766-3404
Practice Address - Fax:602-795-2445
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10272363A00000X
AZ4629363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant