Doctor Name: | ROBERTA LOCK |
NPI Number: | 1073647681 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 92805 |
Business Practice Address: | 106 W North St Cortez, CO - 813213119 |
Business Phone Number: | 9705653056 |
Business Fax Number: | 9705650647 |
Mailing Address: | 21190 Road U, CORTEZ |
State: | CO |
Postal Code: | 813218713 |
Phone Number: | 9708824795 |
Fax Number: | |
NPI Enumeration Date: | 03/15/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC1500X |
License Number: | 92805 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |