MEDICARE: MRS. CHRISTINE E LOCK 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
1	363LW0102X	Women's Health Nurse Practitioner	RN-153579 , NP-05730	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700882099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE E LOCK WHNP

Provider Business Mailing Address
First Line	:	2200 PHILADELPHIA DR
Second Line	:	STE 101
City	:	DAYTON
State	:	OH
Zip	:	45406-1830
Country	:	US
Telephone Number	:	937-277-8988
Fax Number	:	937-277-9035

Provider Business Practice Location Address
First Line	:	2200 PHILADELPHIA DR
Second Line	:	STE 101
City	:	DAYTON
State	:	OH
Zip	:	45406-1830
Country	:	US
Telephone Number	:	937-277-8988
Fax Number	:	937-277-9035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	07/08/2007

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