Healthcare Provider Details

I. General information

NPI: 1043559610
Provider Name (Legal Business Name): DONNA LOCKHART-PHILIP CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DONNA LOCKHART CNM

II. Dates (important events)

Enumeration Date: 02/02/2013
Last Update Date: 01/16/2020
Certification Date: 01/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4007 DIAMOND RUBY
CHRISTIANSTED VI
00820
US

IV. Provider business mailing address

4007 DIAMOND RUBY
CHRISTIANSTED VI
00820
US

V. Phone/Fax

Practice location:
  • Phone: 340-772-7349
  • Fax: 340-772-7427
Mailing address:
  • Phone: 340-772-7349
  • Fax: 340-772-7427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP9423
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: