Provider Demographics
NPI:1578006151
Name:LOCKHART, EMILY NICOLE (RN)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:NICOLE
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:NICOLE
Other - Last Name:HASKELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:47 VAUGHN RD
Mailing Address - Street 2:HUDSON FALLS PRIMARY SCHOOL
Mailing Address - City:HUDSON FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12839-1219
Mailing Address - Country:US
Mailing Address - Phone:518-681-4465
Mailing Address - Fax:
Practice Address - Street 1:47 VAUGHN RD
Practice Address - Street 2:HUDSON FALLS PRIMARY SCHOOL
Practice Address - City:HUDSON FALLS
Practice Address - State:NY
Practice Address - Zip Code:12839-1219
Practice Address - Country:US
Practice Address - Phone:518-681-4465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY667881163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool