| Doctor Name: | KATIE J INCLAN |
| NPI Number: | 1265574438 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 01017 |
| Business Practice Address: | 700 Kevin Dr New Martinsville, WV - 261552757 |
| Business Phone Number: | 3044555545 |
| Business Fax Number: | 3044555573 |
| Mailing Address: | 407 Wheeling Ave, GLEN DALE |
| State: | WV |
| Postal Code: | 260381536 |
| Phone Number: | 3048451500 |
| Fax Number: | 3048451552 |
| NPI Enumeration Date: | 02/13/2007 |
| NPI Last Update Date: | 11/18/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 01017 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |