Provider Demographics
NPI:1568485001
Name:MCBRIDE, KAREN (CNM)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 EAST 6000 SOUTH
Mailing Address - Street 2:
Mailing Address - City:SOUTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405
Mailing Address - Country:US
Mailing Address - Phone:801-337-5800
Mailing Address - Fax:801-337-5809
Practice Address - Street 1:1525 EAST 6000 SOUTH
Practice Address - Street 2:
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405
Practice Address - Country:US
Practice Address - Phone:801-337-5800
Practice Address - Fax:801-337-5809
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2140314402176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT21403144000001OtherBCBS
WY115019700Medicaid
UTD3289Medicaid
UT005571305Medicare PIN
WY115019700Medicaid