Incledon, Laurie A

Incledon, Laurie A is an sole proprietor health care provider with primary practice located at 903 W Martin St , San Antonio TX 78207-0903. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Women's Health, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Incledon, Laurie A can be contacted via phone (210) 358-3582.

Contact Information

Primary practice address
903 W Martin St San Antonio TX 78207-0903
Phone: (210) 358-3582
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Women's Health 363LW0102X 517125 Texas
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X AP107830 Texas

Profile Details

NPI number 1467708933
LBN Legal business name Incledon, Laurie A
Credentials WHNP, CNM
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 1st, 2012
Last updated Jun 24th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467708933 NPPES
Texas Other 324025102 CSHCN
Texas MEDICAID 324025101 CSHCN

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