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Individual

MRS. LAURIE A INCLEDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
WHNP, CNM

Contact information

Practice address
12881 N IH 35, LIVE OAK, TX 78233-2966
(210) 742-6555
Mailing address
12881 N IH 35, LIVE OAK, TX 78233-2966
(210) 742-6555

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
517125
TX
367A00000X
Advanced Practice Midwife
AP107830
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
324025101
TX
01
324025102
CSHCN
TX
Enumeration date
08/01/2012
Last updated
06/13/2025
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