Provider Demographics
NPI:1265023881
Name:LOCKMAN, AMBER NICOLE (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:NICOLE
Last Name:LOCKMAN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:NICOLE
Other - Last Name:CAMERON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PMHNP-BC
Mailing Address - Street 1:6641 TOWER CT
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-0701
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6641 TOWER CT
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-0701
Practice Address - Country:US
Practice Address - Phone:903-918-8569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0003124-C-NP363LP0808X
FLAPRN11014295363LP0808X
TX1035053363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health