Provider Demographics
NPI:1114406246
Name:MCBRIDE, SARAH (AG-CNS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:AG-CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E 30TH ST STE 109
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3323
Mailing Address - Country:US
Mailing Address - Phone:512-544-5555
Mailing Address - Fax:
Practice Address - Street 1:N20W22961 WATERTOWN RD
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-1306
Practice Address - Country:US
Practice Address - Phone:262-875-5070
Practice Address - Fax:866-384-9486
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138429364SG0600X
WI13939-33364SG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology