Provider Demographics
NPI:1083591465
Name:MCBRIDE, JEARICA (NP)
Entity type:Individual
Prefix:
First Name:JEARICA
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7238 COUNTY ROAD 100
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:MS
Mailing Address - Zip Code:38917-7028
Mailing Address - Country:US
Mailing Address - Phone:662-897-4341
Mailing Address - Fax:
Practice Address - Street 1:7238 COUNTY ROAD 100
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:MS
Practice Address - Zip Code:38917-7028
Practice Address - Country:US
Practice Address - Phone:662-897-4341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-19
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS907742363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily