Provider Demographics
NPI:1326319989
Name:LOCKWOOD, SUSAN LYNNE (RN)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:LYNNE
Last Name:LOCKWOOD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COLWELL ST
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:NY
Mailing Address - Zip Code:14801-1335
Mailing Address - Country:US
Mailing Address - Phone:607-359-2241
Mailing Address - Fax:607-359-3443
Practice Address - Street 1:1 COLWELL ST
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:NY
Practice Address - Zip Code:14801-1335
Practice Address - Country:US
Practice Address - Phone:607-359-2241
Practice Address - Fax:607-359-3443
Is Sole Proprietor?:No
Enumeration Date:2012-01-13
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271436163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool