Provider Demographics
NPI:1043941693
Name:LOCKARD, ANDREA CLAIRE (MS, RDN)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:CLAIRE
Last Name:LOCKARD
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 DALE EARNHARDT BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28081-0308
Mailing Address - Country:US
Mailing Address - Phone:704-403-7431
Mailing Address - Fax:
Practice Address - Street 1:201 DALE EARNHARDT BLVD STE 201
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28081-0308
Practice Address - Country:US
Practice Address - Phone:704-403-7431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered