Provider Demographics
NPI:1841954328
Name:LOCKHART, ELIZABETH D (PMHNP)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:D
Last Name:LOCKHART
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:D
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 OLD SOUTH RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-4120
Mailing Address - Country:US
Mailing Address - Phone:636-224-1210
Mailing Address - Fax:636-246-1008
Practice Address - Street 1:4066 DUNNICA AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63116-3510
Practice Address - Country:US
Practice Address - Phone:636-224-1700
Practice Address - Fax:314-535-5917
Is Sole Proprietor?:No
Enumeration Date:2021-10-29
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021040204363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health