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Individual

MRS. MILLICENT JOY LOCKLEAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
10461 HWY 711, PEMBROKE, NC 28372
(910) 775-9292
(919) 775-9444
Mailing address
812 CANDY PARK RD, PEMBROKE, NC 28372-9129
(910) 521-0201
(910) 521-0773

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5006573
NC
363LP0200X
Pediatric Nurse Practitioner
5006573
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5006573
FNP-C LICENSE
NC
Enumeration date
11/04/2013
Last updated
07/15/2024
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