Provider Demographics
NPI:1790509750
Name:LOCKHART, MEREDITH ELIZABETH (RN)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ELIZABETH
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MEREDITH
Other - Middle Name:ELIZABETH
Other - Last Name:DORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:UNIT 28038 BOX US
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09112-8038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UNIT 30401 BOX ARMY
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09154-0401
Practice Address - Country:US
Practice Address - Phone:314-430-7990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS877909163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse