Provider Demographics
NPI:1114916194
Name:LOCKE, ERIN M (MS, RD/LDN, CSSD)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:M
Last Name:LOCKE
Suffix:
Gender:F
Credentials:MS, RD/LDN, CSSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10TH MEDICAL GROUP
Mailing Address - Street 2:4102 PINION DRIVE
Mailing Address - City:U.S. AIR FORCE ACADEMY
Mailing Address - State:CA
Mailing Address - Zip Code:80840
Mailing Address - Country:US
Mailing Address - Phone:719-524-2273
Mailing Address - Fax:
Practice Address - Street 1:4102 PINION DR
Practice Address - Street 2:
Practice Address - City:USAF ACADEMY
Practice Address - State:CO
Practice Address - Zip Code:80840
Practice Address - Country:US
Practice Address - Phone:719-524-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
851744133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered