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NPI Code Detail

MEDICARE: STACY M MCBRIDE APRN

MEDICARE: STACY M MCBRIDE APRN
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 Practitioner3009996KY
2363LF0000XFamily Nurse Practitioner71006073AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P01617618OTHERKYRAILROAD MEDICARE
4P01609813OTHERINRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5000001009424OTHERANTHEM
650105927OTHERKYPASSPORT HEALTH PLAN

General Provider Information

NPI Number : 1588023675
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY M MCBRIDE APRN
Provider Business Mailing Address
First Line : 443 SPRING ST STE 200
Second Line :
City : JEFFERSONVILLE
State : IN
Zip : 47130-4494
Country : US
Telephone Number : 812-288-8360
Fax Number : 812-288-8375
Provider Business Practice Location Address
First Line : 443 SPRING ST STE 200
Second Line :
City : JEFFERSONVILLE
State : IN
Zip : 47130-4494
Country : US
Telephone Number : 812-288-8360
Fax Number : 812-288-8375
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2016
Last Update Date : 04/14/2026

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1598105660 — BROOKE ANN MILLER APRN
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Directions to “ STACY M MCBRIDE APRN” Practice Location

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