Provider Demographics
NPI:1013163054
Name:LOCKARD, JOYCE PENNINGTON (FNP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:PENNINGTON
Last Name:LOCKARD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6330 HIGHWAY 17
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71295-5439
Mailing Address - Country:US
Mailing Address - Phone:318-722-3447
Mailing Address - Fax:318-435-8099
Practice Address - Street 1:2106 LOOP RD STE A
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:LA
Practice Address - Zip Code:71295-3343
Practice Address - Country:US
Practice Address - Phone:318-435-8020
Practice Address - Fax:318-435-8099
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAPO5568363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAAPO5568OtherFNP LICENSE NUMBER