Provider Demographics
NPI:1861287393
Name:LOCKAMY, TABITHA (RN)
Entity type:Individual
Prefix:
First Name:TABITHA
Middle Name:
Last Name:LOCKAMY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:668 OLD SALEMBURG RD
Mailing Address - Street 2:
Mailing Address - City:SALEMBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28385-9015
Mailing Address - Country:US
Mailing Address - Phone:910-260-0968
Mailing Address - Fax:
Practice Address - Street 1:668 OLD SALEMBURG RD
Practice Address - Street 2:
Practice Address - City:SALEMBURG
Practice Address - State:NC
Practice Address - Zip Code:28385-9015
Practice Address - Country:US
Practice Address - Phone:910-260-0968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC364206163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse