Provider Demographics
NPI:1750798013
Name:LOCKARD, JAMIE MARIE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:MARIE
Last Name:LOCKARD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2092 BOLTON RD
Mailing Address - Street 2:
Mailing Address - City:CATAWBA
Mailing Address - State:NC
Mailing Address - Zip Code:28609-8010
Mailing Address - Country:US
Mailing Address - Phone:316-734-8263
Mailing Address - Fax:
Practice Address - Street 1:527 BROOKDALE DR
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-4107
Practice Address - Country:US
Practice Address - Phone:704-278-4053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18940363LF0000X
NC5007804363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily