Healthcare Provider Details

I. General information

NPI: 1962601823
Provider Name (Legal Business Name): CHRISTINE KAY MCBRIDE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINE KAY ALDER

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 11/03/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2751 BAY PARK DR. SUITE #300
OREGON OH
43616
US

IV. Provider business mailing address

2751 BAY PARK DR. SUITE #300
OREGON OH
43616
US

V. Phone/Fax

Practice location:
  • Phone: 419-691-7596
  • Fax: 419-697-6707
Mailing address:
  • Phone: 419-691-7596
  • Fax: 419-697-6707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberNM-09470
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCOA09470NM
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: