Provider Demographics
NPI:1962601823
Name:MCBRIDE, CHRISTINE KAY (CNM)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:KAY
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:KAY
Other - Last Name:ALDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2751 BAY PARK DR.
Mailing Address - Street 2:SUITE #300
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616
Mailing Address - Country:US
Mailing Address - Phone:419-691-7596
Mailing Address - Fax:419-697-6707
Practice Address - Street 1:2751 BAY PARK DR.
Practice Address - Street 2:SUITE #300
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616
Practice Address - Country:US
Practice Address - Phone:419-691-7596
Practice Address - Fax:419-697-6707
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNM-09470176B00000X
OHCOA09470NM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0401797OtherCIGNA
OH2764049Medicaid
CA344428256OtherBEECH STREET
MI1962601823Medicaid
OH344428256OtherHEALTH NET
OH344428256OtherFRONTPATH
OH05225OtherPARAMOUNT
OHMCNM76181Medicare PIN