Healthcare Provider Details

I. General information

NPI: 1699291534
Provider Name (Legal Business Name): MICHELLE SARETTE MCBRIDE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MICHELLE SARETTE MATTHEWS

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 08/18/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 ERIE AVE STE 8
CINCINNATI OH
45208-1656
US

IV. Provider business mailing address

PO BOX 17233
COVINGTON KY
41017-0233
US

V. Phone/Fax

Practice location:
  • Phone: 937-759-0545
  • Fax: 937-759-0549
Mailing address:
  • Phone: 513-505-0354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1142101
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number368237
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number321825
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71016623A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3013854
License Number StateKY
# 6
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.022138
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: