MEDICARE: MS. JAMIE MARIE LOCKARD FNP-C

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	363LF0000X	Family Nurse Practitioner	18940	SC
2	363LF0000X	Family Nurse Practitioner	5007804	NC

General Provider Information

NPI Number	:	1750798013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JAMIE MARIE LOCKARD FNP-C

Provider Business Mailing Address
First Line	:	527 BROOKDALE DR
Second Line	:
City	:	STATESVILLE
State	:	NC
Zip	:	28677-4107
Country	:	US
Telephone Number	:	704-278-4053
Fax Number	:

Provider Business Practice Location Address
First Line	:	527 BROOKDALE DR
Second Line	:
City	:	STATESVILLE
State	:	NC
Zip	:	28677-4107
Country	:	US
Telephone Number	:	704-278-4053
Fax Number	:

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

Provider Enumeration Date	:	07/18/2014
Last Update Date	:	01/19/2026

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