Healthcare Provider Details

I. General information

NPI: 1992609580
Provider Name (Legal Business Name): NAKIYA B LOCKLEAR PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 W 3RD ST
PEMBROKE NC
28372-7977
US

IV. Provider business mailing address

1302 LAURIN LN
LAURINBURG NC
28352-3448
US

V. Phone/Fax

Practice location:
  • Phone: 910-521-5600
  • Fax:
Mailing address:
  • Phone: 910-610-9248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number35086
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: