Provider Demographics
NPI:1467932939
Name:LOCKETT, SHERYL (ARNP)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:LOCKETT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SHERYL
Other - Middle Name:
Other - Last Name:BENNETT- WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:9804 PALAZZO ST
Mailing Address - Street 2:
Mailing Address - City:SEFFNER
Mailing Address - State:FL
Mailing Address - Zip Code:33584-2661
Mailing Address - Country:US
Mailing Address - Phone:813-610-0364
Mailing Address - Fax:
Practice Address - Street 1:9804 PALAZZO ST
Practice Address - Street 2:
Practice Address - City:SEFFNER
Practice Address - State:FL
Practice Address - Zip Code:33584-2661
Practice Address - Country:US
Practice Address - Phone:813-610-0364
Practice Address - Fax:813-988-6323
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3244632363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology