Provider Demographics
NPI:1689038812
Name:MCBRIDE, CODY N (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:CODY
Middle Name:N
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:CODY
Other - Middle Name:N
Other - Last Name:AMSTUTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5224 E I 240 SERVICE RD FL 2
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135-2607
Mailing Address - Country:US
Mailing Address - Phone:405-608-3800
Mailing Address - Fax:405-628-6791
Practice Address - Street 1:5224 E I 240 SERVICE RD FL 2
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73135-2607
Practice Address - Country:US
Practice Address - Phone:405-608-3800
Practice Address - Fax:405-628-6791
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0101964363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily