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Individual

ELLEN NICOLE LOCKWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3820 NORTHDALE BLVD STE 200, TAMPA, FL 33624-1863
(813) 712-5702
(813) 377-1005
Mailing address
38135 MARKET SQ, ZEPHYRHILLS, FL 33542-7505
(352) 567-0188
(813) 355-5101

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9115565
FL
363A00000X
Physician Assistant

Other

Enumeration date
12/04/2021
Last updated
10/21/2022
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