Provider Demographics
NPI:1942685607
Name:MCDADE, EDDIA MARIE (PHD, PMHNP, RN)
Entity Type:Individual
Prefix:DR
First Name:EDDIA
Middle Name:MARIE
Last Name:MCDADE
Suffix:
Gender:F
Credentials:PHD, PMHNP, RN
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Mailing Address - Street 1:1025 HURON AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-3763
Mailing Address - Country:US
Mailing Address - Phone:810-966-6025
Mailing Address - Fax:810-622-3598
Practice Address - Street 1:1025 HURON AVE FL 2
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3763
Practice Address - Country:US
Practice Address - Phone:810-966-6025
Practice Address - Fax:810-622-3598
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-23
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704177892363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health