Provider Demographics
NPI:1669270450
Name:LOCKLEAR, INDIA SMITH (RN)
Entity type:Individual
Prefix:MRS
First Name:INDIA
Middle Name:SMITH
Last Name:LOCKLEAR
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 NC HIGHWAY 711
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28360-5489
Mailing Address - Country:US
Mailing Address - Phone:910-316-8856
Mailing Address - Fax:
Practice Address - Street 1:408 CARTHAGE RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-4523
Practice Address - Country:US
Practice Address - Phone:910-774-4445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC368498163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse