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NPI Code Detail

MEDICARE: KIM ANNE LOCKART WHNP

MEDICARE: KIM ANNE LOCKART WHNP
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
1163W00000XRegistered NurseRN037758AZ
2363LW0102XWomen's Health Nurse PractitionerAP0336AZ

General Provider Information

NPI Number : 1700867603
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM ANNE LOCKART WHNP
Provider Business Mailing Address
First Line : 2920 N 4TH ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86004-0600
Country : US
Telephone Number : 928-213-6100
Fax Number : 928-522-9664
Provider Business Practice Location Address
First Line : 2920 N 4TH ST
Second Line :
City : FLAGSTAFF
State : AZ
Zip : 86004-1816
Country : US
Telephone Number : 928-221-3610
Fax Number : 928-213-6125
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2005
Last Update Date : 11/13/2013

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Directions to “ KIM ANNE LOCKART WHNP” Practice Location

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