Individual
KELLY LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
901 NE INDEPENDENCE AVE, LEES SUMMIT, MO 64086-5544
(816) 347-3288
(816) 554-4263
Mailing address
828 BIRCH ST, BUTLER, MO 64730-1867
(660) 424-0425
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
2009017324
MO
Other
Enumeration date
02/10/2014
Last updated
02/10/2014
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