Provider Demographics
NPI:1598194508
Name:MCBRIDE, JENA (FNP-C)
Entity type:Individual
Prefix:
First Name:JENA
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2078
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-6156
Mailing Address - Country:US
Mailing Address - Phone:817-369-5876
Mailing Address - Fax:817-738-3296
Practice Address - Street 1:133 N FM 730 UNIT 105
Practice Address - Street 2:
Practice Address - City:BOYD
Practice Address - State:TX
Practice Address - Zip Code:76023-3072
Practice Address - Country:US
Practice Address - Phone:940-433-2151
Practice Address - Fax:940-433-2366
Is Sole Proprietor?:No
Enumeration Date:2013-11-11
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX671423363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX335305401Medicaid
TX8098NJOtherBCBS
TX8098NJOtherBCBS
TX327837YY17Medicare PIN
TX335305401Medicaid