Provider Demographics
NPI:1144916768
Name:LOCKRIDGE, ROCKEYA LYNN (CNA)
Entity type:Individual
Prefix:
First Name:ROCKEYA
Middle Name:LYNN
Last Name:LOCKRIDGE
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 CAROLINE AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46218-2754
Mailing Address - Country:US
Mailing Address - Phone:317-854-2480
Mailing Address - Fax:
Practice Address - Street 1:2710 CAROLINE AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46218-2754
Practice Address - Country:US
Practice Address - Phone:317-854-2480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INCNA1905907376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
INCNA1905907OtherINDIANA STATE DEPARTMENT OF HEALTH