Healthcare Provider Details

I. General information

NPI: 1558295816
Provider Name (Legal Business Name): REBECCA LOCKLEAR APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 LAMBERT RD
BISCOE NC
27209-9002
US

IV. Provider business mailing address

11780 US HIGHWAY 1 STE N107
PALM BEACH GARDENS FL
33408-3007
US

V. Phone/Fax

Practice location:
  • Phone: 910-428-2117
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number5024642
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: