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General NPI Number Information
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NPI Number | 1376402842
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Entity Type | Individual
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Provider Name | COURTNEY LOCKWOOD
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Gender | Female
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Dates
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Enumeration Date | 01/20/2026
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 2900 W OKLAHOMA AVE
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City | MILWAUKEE
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State | WI
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Zip | 53215-4330
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Country | US
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Telephone | 414-649-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 1636 W FAIRFIELD CT
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City | GLENDALE
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State | WI
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Zip | 53209-3433
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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 | 242T00000X
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Taxonomy Name | Perfusionist
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License Number | 262-18
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License Number State | WI
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