Individual
DIANNE LYNN LOCKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., RN, CNS
Contact information
Practice address
3919 W 44TH ST STE 200, EDINA, MN 55424-1032
(952) 922-1977
(952) 922-1980
Mailing address
3919 W 44TH ST STE 200, EDINA, MN 55424-1032
(952) 922-1977
(952) 922-1980
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
R055788
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4H897LO
BLUE SHIELD INDIVIDUAL
MN
Enumeration date
05/01/2007
Last updated
07/08/2007
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