Provider Demographics
NPI:1083189294
Name:AUBRY, KATELYN JO (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:JO
Last Name:AUBRY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:JO
Other - Last Name:COINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:PO BOX 1680
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25717-1680
Mailing Address - Country:US
Mailing Address - Phone:304-781-5159
Mailing Address - Fax:304-523-8115
Practice Address - Street 1:864 OAKWOOD RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25314-2010
Practice Address - Country:US
Practice Address - Phone:304-343-2807
Practice Address - Fax:678-265-5161
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV85871363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily