Provider Demographics
NPI:1831638824
Name:LOCKHEART, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:LOCKHEART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43839 N 15TH ST WEST
Mailing Address - Street 2:HIGH DESERT MEDICAL CORP
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-4659
Mailing Address - Country:US
Mailing Address - Phone:661-945-5984
Mailing Address - Fax:661-951-3192
Practice Address - Street 1:43839 N 15TH ST WEST
Practice Address - Street 2:HIGH DESERT MEDICAL CORP
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4659
Practice Address - Country:US
Practice Address - Phone:661-945-5984
Practice Address - Fax:661-951-3350
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95006180363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily