Provider Demographics
NPI:1699239814
Name:LOCKWOOD, HALEY RENAE (APRN, CNM)
Entity type:Individual
Prefix:
First Name:HALEY
Middle Name:RENAE
Last Name:LOCKWOOD
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:HALEY
Other - Middle Name:RENAE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, CNM
Mailing Address - Street 1:555 W SUN ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-1563
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:245 FLEMINGSBURG RD
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-1015
Practice Address - Country:US
Practice Address - Phone:606-207-2931
Practice Address - Fax:606-783-0964
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC715176B00000X
KY3016173367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife