Individual
MARY ELLEN MCBRIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3707 SW 6TH AVE, TOPEKA, KS 66606-2084
(785) 270-4630
(785) 270-4628
Mailing address
3707 SW 6TH AVE, TOPEKA, KS 66606-2084
(785) 270-4630
(785) 270-4628
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
74086
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
74086
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11066016
MEDICARE PTAN
KS
05
—
200282870
—
KS
Enumeration date
08/03/2006
Last updated
11/07/2014
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