Individual
BETH ANN LOCKWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
PO BOX 106, WAKARUSA, IN 46573-0106
(574) 900-1191
(574) 900-1193
Mailing address
PO BOX 106, WAKARUSA, IN 46573-0106
(574) 900-1191
(574) 900-1193
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71007836A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300012921
—
IN
Enumeration date
06/27/2016
Last updated
05/08/2024
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