Healthcare Provider Details

I. General information

NPI: 1629326863
Provider Name (Legal Business Name): MARGARET HOOVER MCBRIDE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2012
Last Update Date: 08/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 CLAIRMONT ROAD ATLANTA VA MEDICAL CENTER
DECATUR GA
30033
US

IV. Provider business mailing address

567 CULBERSON ST SW
ATLANTA GA
30310-1737
US

V. Phone/Fax

Practice location:
  • Phone: 404-321-6111
  • Fax: 404-417-1540
Mailing address:
  • Phone: 678-528-4543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN080033
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: