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General NPI Number Information
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NPI Number | 1942637103
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Entity Type | Individual
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Provider Name | DEBORAH RENEE LOCKE PA
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Gender | Female
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Dates
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Enumeration Date | 10/02/2013
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 9900 S RURAL RD
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City | TEMPE
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State | AZ
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Zip | 85284-4116
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Country | US
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Telephone | 480-783-6257
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 932958
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City | CLEVELAND
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State | OH
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Zip | 44193-0028
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Country | US
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Telephone | 615-425-4200
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Fax | 615-425-4201
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5493
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 016897-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5493
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License Number State | AZ
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