Provider Demographics
NPI:1043337058
Name:MCBRIDE, BERNADETTE MARIE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:BERNADETTE
Middle Name:MARIE
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 JENNA RD
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-7338
Mailing Address - Country:US
Mailing Address - Phone:509-627-7745
Mailing Address - Fax:509-627-0153
Practice Address - Street 1:2621 W ENTIAT AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3078
Practice Address - Country:US
Practice Address - Phone:509-460-0642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007099363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8858966Medicare ID - Type Unspecified
WAQ65149Medicare UPIN