MEDICARE: MR. CYNTHIA LOUISE MCBRIDE RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WS0200X	School Registered Nurse	RN 24731	SC

General Provider Information

NPI Number	:	1295170942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CYNTHIA LOUISE MCBRIDE RN

Provider Business Mailing Address
First Line	:	1825 REMOUNT RD
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-3238
Country	:	US
Telephone Number	:	843-745-7109
Fax Number	:

Provider Business Practice Location Address
First Line	:	1825 REMOUNT RD
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29406-3238
Country	:	US
Telephone Number	:	843-745-7109
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2013
Last Update Date	:	05/08/2013

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