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NPI Code Detail

MEDICARE: DIANNE L LOCKE APRN, BC

MEDICARE:   DIANNE L LOCKE  APRN, BC
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
1363LA2200XAdult Health Nurse Practitioner0024067494VA

General Provider Information

NPI Number : 1871585117
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANNE L LOCKE APRN, BC
Provider Business Mailing Address
First Line : 7728 CENTERBROOK CT
Second Line :
City : CHESTERFIELD
State : VA
Zip : 23832-9223
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1201 BROAD ROCK RD
Second Line :
City : RICHMOND
State : VA
Zip : 23249
Country : US
Telephone Number : 804-675-5605
Fax Number : 804-675-5472
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 12/17/2007

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Directions to “ DIANNE L LOCKE APRN, BC” Practice Location

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