Provider Demographics
NPI:1447058938
Name:LOCKLEAR, BIANCA SKY CLARA
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:SKY CLARA
Last Name:LOCKLEAR
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SAND ISLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-4326
Mailing Address - Country:US
Mailing Address - Phone:808-277-0648
Mailing Address - Fax:
Practice Address - Street 1:400 SAND ISLAND PKWY
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-4326
Practice Address - Country:US
Practice Address - Phone:808-277-0648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No183700000XPharmacy Service ProvidersPharmacy Technician