Provider Demographics
NPI:1780986323
Name:LOCK, ERIN ELIZABETH (ACNP-BC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ELIZABETH
Last Name:LOCK
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 S GREENE ST,
Mailing Address - Street 2:3RD FLOOR SHOCK TRAUMA ORTHOPAEDICS
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201
Mailing Address - Country:US
Mailing Address - Phone:410-328-6280
Mailing Address - Fax:410-328-2893
Practice Address - Street 1:22 S GREENE ST,
Practice Address - Street 2:3RD FLOOR SHOCK TRAUMA ORTHOPAEDICS
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201
Practice Address - Country:US
Practice Address - Phone:410-328-6280
Practice Address - Fax:410-328-2893
Is Sole Proprietor?:No
Enumeration Date:2010-12-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-008473363LA2100X
MDR197933363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL522000014Medicare PIN