Provider Demographics
NPI:1932220761
Name:LOCKWOOD, SUZANNE F (APRN)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:F
Last Name:LOCKWOOD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 4TH ST
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-3649
Mailing Address - Country:US
Mailing Address - Phone:406-395-4305
Mailing Address - Fax:406-395-5997
Practice Address - Street 1:312 3RD ST
Practice Address - Street 2:CENTER FOR MENTAL HEALTH
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-3534
Practice Address - Country:US
Practice Address - Phone:406-265-9639
Practice Address - Fax:406-265-6771
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8700363LP0808X
MT99968363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000098233OtherBCBS PROVIDER NUMBER
MTP00692127 C01340OtherRAILROAD MEDICARE
MTML0131716OtherDEA NUMBER
MTML0131716OtherDEA NUMBER
MT000084483Medicare ID - Type Unspecified