Provider Demographics
NPI:1922447358
Name:MCBRIDE, JANET LEE
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LEE
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 1:551 B WEST SMALL CREEK LANE
Mailing Address - Street 2:
Mailing Address - City:CADDO
Mailing Address - State:OK
Mailing Address - Zip Code:74729
Mailing Address - Country:US
Mailing Address - Phone:580-889-1512
Mailing Address - Fax:
Practice Address - Street 1:551 W SMALL CREEK LN
Practice Address - Street 2:
Practice Address - City:CADDO
Practice Address - State:OK
Practice Address - Zip Code:74729-5425
Practice Address - Country:US
Practice Address - Phone:580-889-1512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator