Individual
KRYSTAL SHANTA LOCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
9677 HIGHWAY 21, ATMORE, AL 36502-4271
(251) 368-8122
Mailing address
6424 HAMPTON PARK CT, MOBILE, AL 36608-6800
(251) 490-3477
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-148564
AL
363LA2200X
Adult Health Nurse Practitioner
1-148564
AL
363LG0600X
Gerontology Nurse Practitioner
1-148564
AL
363LP2300X
Primary Care Nurse Practitioner
1-148564
AL
Other
Enumeration date
06/08/2018
Last updated
06/08/2018
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