Individual
GWENDOLYN LEE LOCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 D ST, GERING, NE 69341-3900
(308) 436-3125
(308) 436-4398
Mailing address
336 W 20TH ST, SCOTTSBLUFF, NE 69361-1907
(308) 436-3125
(308) 436-4398
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
6242
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
476005311
—
NE
Enumeration date
03/20/2019
Last updated
03/20/2019
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