Provider Demographics
NPI:1013421205
Name:LOCKETT, ANTOYNAE A (CNM)
Entity Type:Individual
Prefix:
First Name:ANTOYNAE
Middle Name:A
Last Name:LOCKETT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:ANTOYNAE
Other - Middle Name:A
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 SEAGATE STE 800
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1558
Mailing Address - Country:US
Mailing Address - Phone:567-585-1992
Mailing Address - Fax:419-824-7359
Practice Address - Street 1:2751 BAY PARK DR STE 300
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-4922
Practice Address - Country:US
Practice Address - Phone:419-690-7596
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-27
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNM.019352367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife