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Individual

MRS. DESTINY H LOCKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
155 HEALTH WAY, SUITE 2, MC MINNVILLE, TN 37110-2658
(931) 473-4214
(931) 473-0666
Mailing address
155 HEALTH WAY, SUITE 2, MC MINNVILLE, TN 37110-2658
(931) 473-4214
(931) 473-0666

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
APN0000007194
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3719062
TN
05
3732438
TN
05
3904079
TN
01
4167862
BCBST
Enumeration date
06/07/2006
Last updated
05/22/2008
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