Provider Demographics
NPI:1447988100
Name:LOCKS, TRACEY
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:LOCKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4117 AMES ST NE APT 203
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-3346
Mailing Address - Country:US
Mailing Address - Phone:202-751-1737
Mailing Address - Fax:
Practice Address - Street 1:2908 16TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1822
Practice Address - Country:US
Practice Address - Phone:202-269-0375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant