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General NPI Number Information
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NPI Number | 1336344514
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Entity Type | Individual
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Provider Name | KATHLEEN MCBRIDE CRNA, FNP
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Gender | Female
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 6644 E BAYWOOD AVE
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City | MESA
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State | AZ
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Zip | 85206-1747
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Country | US
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Telephone | 480-321-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1370
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City | HEREFORD
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State | AZ
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Zip | 85615-1370
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Country | US
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Telephone | 520-378-2590
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Fax | 520-378-4024
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN039208 AP0867
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN039208 CRNA0039
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License Number State | AZ
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