Provider Demographics
NPI:1699957373
Name:MCBRIDE, BERNADETTE
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 ROUTE 6
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:CT
Mailing Address - Zip Code:06232-1206
Mailing Address - Country:US
Mailing Address - Phone:860-742-9229
Mailing Address - Fax:
Practice Address - Street 1:24 HENDEE RD
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:CT
Practice Address - Zip Code:06238-1540
Practice Address - Country:US
Practice Address - Phone:860-742-9257
Practice Address - Fax:860-742-5086
Is Sole Proprietor?:No
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTE55070163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse