Individual
KATHRYN J CLAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
936 STATE ROUTE 160, GALLIPOLIS, OH 45631-8243
(740) 446-4600
Mailing address
PO BOX 390, HUNTINGTON, WV 25708-0390
(304) 429-1088
(304) 429-3109
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.0035068
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117747
WV LICENSE
WV
01
—
APRN.CNP.0035068
APRN LICENSE
OH
Enumeration date
10/04/2023
Last updated
12/12/2023
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