Individual
MRS. LYNETTE LOCKRIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
439 WILLIE LOU, EGYPT, TX 77436
(832) 279-9818
Mailing address
P.O. BOX 284, EGYPT, TX 77436-0284
(832) 279-9818
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
621054
TX
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
Other
Enumeration date
08/26/2015
Last updated
02/03/2017
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