Individual
TONYA R. JACKSON-LOCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
200 12TH STREET EXT, PRINCETON, WV 24740-2329
(304) 425-9541
Mailing address
200 12TH STREET EXT, PRINCETON, WV 24740-2329
(304) 425-9541
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F04210702
WV
Other
Enumeration date
08/30/2021
Last updated
07/21/2026
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