Provider Demographics
NPI:1366806259
Name:LOCKARD, ALICIA M (DNP, APRN)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:M
Last Name:LOCKARD
Suffix:
Gender:F
Credentials:DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 S HORSEBARN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-8797
Mailing Address - Country:US
Mailing Address - Phone:888-450-9191
Mailing Address - Fax:
Practice Address - Street 1:2907 E JOYCE BLVD STE 5
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5390
Practice Address - Country:US
Practice Address - Phone:479-841-7795
Practice Address - Fax:512-549-8481
Is Sole Proprietor?:No
Enumeration Date:2016-04-07
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA006153363LA2100X, 363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology