Healthcare Provider Details
I. General information
NPI: 1710955059
Provider Name (Legal Business Name): ISABELLE BONNIE BAIRD A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/11/2006
Last Update Date: 03/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2318 MANATEE AVE W
BRADENTON FL
34205-5432
US
IV. Provider business mailing address
700 8TH AVE W STE 101
PALMETTO FL
34221-4737
US
V. Phone/Fax
- Phone: 941-776-4008
- Fax: 941-845-4963
- Phone: 941-776-4008
- Fax: 941-845-4963
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LX0001X |
| Taxonomy | Obstetrics & Gynecology Nurse Practitioner |
| License Number | ARNP1087152 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: