Provider Demographics
NPI:1457859449
Name:MCBRIDE, ALICE FERN
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:FERN
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 1:6705 CORBITT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-2425
Mailing Address - Country:US
Mailing Address - Phone:314-397-8576
Mailing Address - Fax:
Practice Address - Street 1:6705 CORBITT AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63130-2425
Practice Address - Country:US
Practice Address - Phone:314-397-8576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health