MEDICARE: YVONNE MARIE MCBRIDE NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	53-80746-062	KS

General Provider Information

NPI Number	:	1316605496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YVONNE MARIE MCBRIDE NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	10424 QUARRY RD
Second Line	:
City	:	MILFORD
State	:	KS
Zip	:	66514-9300
Country	:	US
Telephone Number	:	785-307-4961
Fax Number	:

Provider Business Practice Location Address
First Line	:	10424 QUARRY RD
Second Line	:
City	:	MILFORD
State	:	KS
Zip	:	66514-9300
Country	:	US
Telephone Number	:	785-307-4961
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2021
Last Update Date	:	12/09/2021

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Directions to “ YVONNE MARIE MCBRIDE NURSE PRACTITIONER” Practice Location

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