Provider Demographics
NPI:1386839835
Name:LOCKHART, SHEARLL DENECE (LPN)
Entity Type:Individual
Prefix:MS
First Name:SHEARLL
Middle Name:DENECE
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON
Mailing Address - State:TN
Mailing Address - Zip Code:38344-1703
Mailing Address - Country:US
Mailing Address - Phone:731-986-1990
Mailing Address - Fax:731-986-1995
Practice Address - Street 1:633 HIGH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGDON
Practice Address - State:TN
Practice Address - Zip Code:38344-1703
Practice Address - Country:US
Practice Address - Phone:731-986-1990
Practice Address - Fax:731-986-1995
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26786164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse