Provider Demographics
NPI:1962031039
Name:LOCKLEAR, JASMINE MARIE (NP-C)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:MARIE
Last Name:LOCKLEAR
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705A WESLEY PINES RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2105
Mailing Address - Country:US
Mailing Address - Phone:910-885-5951
Mailing Address - Fax:
Practice Address - Street 1:2334 SOUTH 41ST ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5502
Practice Address - Country:US
Practice Address - Phone:800-999-9883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-02
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5012999363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily