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General NPI Number Information
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NPI Number | 1013560697
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Entity Type | Individual
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Provider Name | KIM LOCKLEAR RECKER FNP
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Gender | Female
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Dates
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Enumeration Date | 07/22/2019
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 4901 DAWN DR STE 3200
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City | LUMBERTON
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State | NC
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Zip | 28360-8288
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Country | US
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Telephone | 910-735-8040
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Fax | 910-735-8045
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Provider Business Mailing Address
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Address Line | 5221 PARAMOUNT PKWY STE 220
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City | MORRISVILLE
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State | NC
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Zip | 27560-5490
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F07190504
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5013787
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License Number State | NC
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