Provider Demographics
NPI:1760674857
Name:LOCKMAN, JERI L (CNP)
Entity Type:Individual
Prefix:MS
First Name:JERI
Middle Name:L
Last Name:LOCKMAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:OFFICE OF MEDICAL SERVICES
Mailing Address - Street 2:2401 E. ST., NW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20520-0001
Mailing Address - Country:US
Mailing Address - Phone:703-875-5411
Mailing Address - Fax:
Practice Address - Street 1:OFFICE OF MEDICAL SERVICES
Practice Address - Street 2:2401 E. ST., NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20520-0001
Practice Address - Country:US
Practice Address - Phone:703-875-5411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR38483363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health