Provider Demographics
NPI:1760833693
Name:LOCKARD, CHRISTOPHER (APRN)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:LOCKARD
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3172 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STAMPING GROUND
Mailing Address - State:KY
Mailing Address - Zip Code:40379-9705
Mailing Address - Country:US
Mailing Address - Phone:502-370-6066
Mailing Address - Fax:
Practice Address - Street 1:3172 MAIN ST
Practice Address - Street 2:
Practice Address - City:STAMPING GROUND
Practice Address - State:KY
Practice Address - Zip Code:40379-9705
Practice Address - Country:US
Practice Address - Phone:502-370-6066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010363363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily