Individual
TONYA R. JACKSON-LOCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
223 GELDING ST, PRINCETON, WV 24740-3811
(304) 320-3692
Mailing address
PO BOX 5135, PRINCETON, WV 24740-5135
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F04210702
WV
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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