Individual
LAURA BEASLEY LOCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
923 E CENTRAL AVE, LA FOLLETTE, TN 37766-2768
(423) 907-1200
(865) 291-3228
Mailing address
304 WRIGHT ST, SWEETWATER, TN 37874-1181
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8105
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4057237
BCBS
TN
05
—
78015559
—
KY
01
—
P00295811
MEDICARE RAILROAD
TN
Enumeration date
06/05/2006
Last updated
02/03/2020
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