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Individual

MRS. TRACY LOCKETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
2676 SW IMMANUEL DR, PALM CITY, FL 34990-2738
(772) 219-4444
(772) 219-0550
Mailing address
4591 SE HANOVER CT, STUART, FL 34997-2458
(772) 288-4876

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
ARNP 2706482
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
306930300
FL
Enumeration date
08/30/2006
Last updated
07/09/2007
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