Provider Demographics
NPI:1609573773
Name:MCBRIDE, ANNE MARIE (APRN)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:439 S PLEASANT GROVE BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-3493
Mailing Address - Country:US
Mailing Address - Phone:800-640-3451
Mailing Address - Fax:
Practice Address - Street 1:7115 BLANCO RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-5045
Practice Address - Country:US
Practice Address - Phone:800-640-3451
Practice Address - Fax:210-566-8333
Is Sole Proprietor?:No
Enumeration Date:2023-02-09
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1103203363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner