Provider Demographics
NPI:1588548218
Name:LOCKETT, TERRIA L (APRN FNP)
Entity type:Individual
Prefix:
First Name:TERRIA
Middle Name:L
Last Name:LOCKETT
Suffix:
Gender:F
Credentials:APRN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 THORNTON CT
Mailing Address - Street 2:
Mailing Address - City:MACEDONIA
Mailing Address - State:OH
Mailing Address - Zip Code:44056-2072
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:440-460-2819
Practice Address - Street 1:6770 MAYFIELD RD STE 226
Practice Address - Street 2:
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2299
Practice Address - Country:US
Practice Address - Phone:440-461-6430
Practice Address - Fax:440-460-2819
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHF0425008208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology