Lockett, Tracy

Lockett, Tracy is an sole proprietor health care provider with primary practice located at 2676 Sw Immanuel Dr , Palm City FL 34990-2738. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Lockett, Tracy can be contacted via phone (772) 219-4444.

Contact Information

Primary practice address
2676 Sw Immanuel Dr Palm City FL 34990-2738
Phone: (772) 219-4444
Fax: (772) 219-0550
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X ARNP 2706482 Florida

Profile Details

NPI number 1659481158
LBN Legal business name Lockett, Tracy
Credentials ARNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659481158 NPPES
Florida MEDICAID 306930300

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