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Individual

JACKIE LOCKLEAR CHAVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
101 CABARRUS AVE E, CONCORD, NC 28025-3699
(910) 703-2658
Mailing address
517 BLACKFOOT TRL, MAXTON, NC 28364-6086
(910) 703-2658

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5017020
NC

Other

Enumeration date
10/04/2022
Last updated
04/19/2023
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