Provider Demographics
NPI:1982252052
Name:LOCKLEAR, SHEENA
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:
Last Name:LOCKLEAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 PRESTON BROOK DR
Mailing Address - Street 2:
Mailing Address - City:CATAWBA
Mailing Address - State:SC
Mailing Address - Zip Code:29704-9711
Mailing Address - Country:US
Mailing Address - Phone:704-733-0864
Mailing Address - Fax:
Practice Address - Street 1:560 PRESTON BROOK DR
Practice Address - Street 2:
Practice Address - City:CATAWBA
Practice Address - State:SC
Practice Address - Zip Code:29704-9711
Practice Address - Country:US
Practice Address - Phone:704-733-0864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-30
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion