Provider Demographics
NPI:1689130015
Name:LOCKHART, JESSICA COE (DNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:COE
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 LEVINE RD
Mailing Address - Street 2:
Mailing Address - City:ODENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35120-6624
Mailing Address - Country:US
Mailing Address - Phone:615-906-6930
Mailing Address - Fax:
Practice Address - Street 1:70 PLAZA DR
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-9314
Practice Address - Country:US
Practice Address - Phone:205-814-9284
Practice Address - Fax:205-814-9626
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL161871163WG0000X
AL1-161871363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice