Provider Demographics
NPI:1356488555
Name:LOCKLIN, VELVET DAWN (RN)
Entity type:Individual
Prefix:MRS
First Name:VELVET
Middle Name:DAWN
Last Name:LOCKLIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:PO BOX 18
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:WY
Mailing Address - Zip Code:82636-0018
Mailing Address - Country:US
Mailing Address - Phone:307-472-9224
Mailing Address - Fax:307-472-9224
Practice Address - Street 1:11002 RIDGEVIEW RD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:WY
Practice Address - Zip Code:82636-9825
Practice Address - Country:US
Practice Address - Phone:307-267-4101
Practice Address - Fax:307-234-9329
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY22371163W00000X
251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No251C00000XAgenciesDay Training, Developmentally Disabled Services