Provider Demographics
NPI:1669656468
Name:LOCKHART, KEISHA DENISE (MSN, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:KEISHA
Middle Name:DENISE
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CHIDRENS HOSPITAL OF PHILADELPHIA
Mailing Address - Street 2:100 MANOR DRIVE
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-1308
Mailing Address - Country:US
Mailing Address - Phone:215-572-7880
Mailing Address - Fax:215-572-8024
Practice Address - Street 1:CHIDRENS HOSPITAL OF PHILADELPHIA
Practice Address - Street 2:100 MANOR DRIVE
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-1308
Practice Address - Country:US
Practice Address - Phone:215-572-7880
Practice Address - Fax:215-572-8024
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP009531363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics