Provider Demographics
NPI:1669786380
Name:MCBRIDE, TARSHA MEDLEY (RN)
Entity type:Individual
Prefix:
First Name:TARSHA
Middle Name:MEDLEY
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1273
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-1273
Mailing Address - Country:US
Mailing Address - Phone:919-346-3171
Mailing Address - Fax:
Practice Address - Street 1:211 E QUAILWOOD DR
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-4301
Practice Address - Country:US
Practice Address - Phone:919-346-3171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC206930163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC206930OtherNORTH CAROLINA BOARD OF NURSING LICENCE