Provider Demographics
NPI:1518168384
Name:LOCKEE, DANA RENAE (MD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:RENAE
Last Name:LOCKEE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 67099
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-7099
Mailing Address - Country:US
Mailing Address - Phone:402-423-7774
Mailing Address - Fax:402-423-7774
Practice Address - Street 1:1730 S 70TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1613
Practice Address - Country:US
Practice Address - Phone:402-484-6600
Practice Address - Fax:402-484-6610
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE26534207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025092100Medicaid