Healthcare Provider Details

I. General information

NPI: 1437522018
Provider Name (Legal Business Name): STEPHANIE RAIE MCBRIDE WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2015
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

721 DEPOT DR
ANCHORAGE AK
99501-1615
US

IV. Provider business mailing address

721 DEPOT DR
ANCHORAGE AK
99501-1615
US

V. Phone/Fax

Practice location:
  • Phone: 888-731-8994
  • Fax:
Mailing address:
  • Phone: 888-731-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberC-APN.1001938-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number105659
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95006562
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number023747
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: