MEDICARE: MEGAN MCBRIDE FNP

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	363LF0000X	Family Nurse Practitioner	2023048694	MO

General Provider Information

NPI Number	:	1750158630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MCBRIDE FNP

Provider Business Mailing Address
First Line	:	1000 N JEFFERSON ST
Second Line	:
City	:	SAINT JAMES
State	:	MO
Zip	:	65559-1078
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 N JEFFERSON ST
Second Line	:
City	:	SAINT JAMES
State	:	MO
Zip	:	65559-1078
Country	:	US
Telephone Number	:	573-265-8840
Fax Number	:

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

Provider Enumeration Date	:	12/11/2023
Last Update Date	:	01/02/2024

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