Provider Demographics
NPI:1457968273
Name:LOCKETT, ZANETA MAE
Entity Type:Individual
Prefix:MRS
First Name:ZANETA
Middle Name:MAE
Last Name:LOCKETT
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 1:6905 GETTYSBURG DR
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-3248
Mailing Address - Country:US
Mailing Address - Phone:419-882-6523
Mailing Address - Fax:
Practice Address - Street 1:6905 GETTYSBURG DR
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-3248
Practice Address - Country:US
Practice Address - Phone:419-882-6523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide