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:
Health care specialties
| Specialty | Code | License # | 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 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467708933 | NPPES |
| Texas | Other | 324025102 | CSHCN |
| Texas | MEDICAID | 324025101 | CSHCN |
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