Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Mary Rose Locke

Individual provider Family Nurse Practitioner · NPI 1376930404

Mrs. Mary Rose Locke is a Nurse Practitioner in Austell, Georgia. Qualified in 2014, 12 years ago. Accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
12
Licensed in
GA
In the registry since
2015
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Practice location Address checks out

1620 Mulkey Rd Ste 100
Austell, GA 30106-1171
Phone: (770) 953-3331
Fax: (770) 739-9609
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN198225 (GA)

Record details

NPI number1376930404
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 15, 2015
Last updated in NPPESJanuary 20, 2022
Certification dateJanuary 20, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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