Provider Demographics
NPI:1861581886
Name:MCBRIDE, DEBORAH HODGE (CRNP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:HODGE
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1066 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36067-7067
Mailing Address - Country:US
Mailing Address - Phone:334-365-2825
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL PENSACOLA
Practice Address - Street 2:6000 WEST HIGHWAY 98
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32512-0001
Practice Address - Country:US
Practice Address - Phone:850-505-6199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2017-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-086040363L00000X, 363LF0000X, 363LP0200X
FLARNP 9355941363LF0000X, 363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051555428MCBOtherPIN
AL515-36201OtherBC/BS
AL515-36201OtherBC/BS