Provider Demographics
NPI:1699291534
Name:MCBRIDE, MICHELLE SARETTE (APRN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:SARETTE
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:SARETTE
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4760 MADISON RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-1426
Mailing Address - Country:US
Mailing Address - Phone:513-321-8286
Mailing Address - Fax:513-751-0180
Practice Address - Street 1:4760 MADISON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-1426
Practice Address - Country:US
Practice Address - Phone:513-321-8286
Practice Address - Fax:513-751-0180
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH368237163W00000X
OHAPRN.CNP.022138363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse