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NPI Code Detail

MEDICARE: TRACY L. MCBRIDE NP

MEDICARE: TRACY L. MCBRIDE NP
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
1363LF0000XFamily Nurse Practitioner71001448AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000659189OTHERINANTHEM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487612446
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY L. MCBRIDE NP
Provider Business Mailing Address
First Line : 6626 E. 75 TH ST
Second Line : SUITE 500
City : INDIANAPOLIS
State : IN
Zip : 46250-2890
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8177 CLEARVISTA PKWY
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-1662
Country : US
Telephone Number : 317-621-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 07/21/2015

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