Individual
LAUREN LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13963 MORSE ST, CEDAR LAKE, IN 46303-9639
(219) 374-5555
Mailing address
13963 MORSE ST, CEDAR LAKE, IN 46303-9639
(219) 374-5555
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28210044A
IN
363LF0000X
Family Nurse Practitioner
Primary
71008561A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
714850342
—
IN
Enumeration date
10/18/2018
Last updated
12/02/2019
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