| Doctor Name: | KRISTIN J LOCKREM |
| NPI Number: | 1467421008 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 5601003243 |
| Business Practice Address: | 406 N State St Gobles, MI - 490559717 |
| Business Phone Number: | 2696282196 |
| Business Fax Number: | 2696282363 |
| Mailing Address: | 551 Linn St, ALLEGAN |
| State: | MI |
| Postal Code: | 490101595 |
| Phone Number: | 2696865800 |
| Fax Number: | 2696865899 |
| NPI Enumeration Date: | 03/16/2006 |
| NPI Last Update Date: | 01/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 5601003243 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |