Provider Demographics
NPI:1245295724
Name:MCBRIDE, TERRIL MIRIAM (CRNP)
Entity type:Individual
Prefix:MRS
First Name:TERRIL
Middle Name:MIRIAM
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:TERRIL
Other - Middle Name:MCBRIDE
Other - Last Name:DONNELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:323 SUNSET DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4017
Mailing Address - Country:US
Mailing Address - Phone:724-282-2730
Mailing Address - Fax:724-282-3004
Practice Address - Street 1:2 CASCADE GALLERIA PLAZA
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101
Practice Address - Country:US
Practice Address - Phone:724-658-6681
Practice Address - Fax:724-658-6883
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN237027L163W00000X
PATP001885F363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA877387L5TMedicare PIN
PAMC877387OtherHIGHMARK
S38455Medicare UPIN
PA877387L56Medicare PIN
PA877387PAZMedicare PIN
PAP00352210OtherMEDICARE/RAILROAD CARRIER
PA1991407OtherHIGHMARK