Provider Demographics
NPI:1700882099
Name:LOCK, CHRISTINE E (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:E
Last Name:LOCK
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2200 PHILADELPHIA DR
Mailing Address - Street 2:STE 101
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-1830
Mailing Address - Country:US
Mailing Address - Phone:937-277-8988
Mailing Address - Fax:937-277-9035
Practice Address - Street 1:2200 PHILADELPHIA DR
Practice Address - Street 2:STE 101
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-1830
Practice Address - Country:US
Practice Address - Phone:937-277-8988
Practice Address - Fax:937-277-9035
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHRN-153579 , NP-05730363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2266239Medicaid
OH2266239Medicaid