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NPI Code Detail

MEDICARE: ROCKEYA LYNN LOCKRIDGE CNA

MEDICARE:   ROCKEYA LYNN LOCKRIDGE  CNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1376K00000XNurse's AideCNA1905907IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CNA1905907OTHERININDIANA STATE DEPARTMENT OF HEALTH

General Provider Information

NPI Number : 1144916768
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROCKEYA LYNN LOCKRIDGE CNA
Provider Business Mailing Address
First Line : 2710 CAROLINE AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46218-2754
Country : US
Telephone Number : 317-854-2480
Fax Number :
Provider Business Practice Location Address
First Line : 2710 CAROLINE AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46218-2754
Country : US
Telephone Number : 317-854-2480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2023
Last Update Date : 04/17/2023

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Directions to “ ROCKEYA LYNN LOCKRIDGE CNA” Practice Location

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