Healthcare Provider Details

I. General information

NPI: 1538073903
Provider Name (Legal Business Name): CHARSPAR HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 W 2200 S APT T103
LOGAN UT
84321-6648
US

IV. Provider business mailing address

945 W 2200 S
LOGAN UT
84321-6591
US

V. Phone/Fax

Practice location:
  • Phone: 385-227-1209
  • Fax:
Mailing address:
  • Phone: 385-227-1209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROBERT PAUL BAIRD
Title or Position: OWNER
Credential: DNP PMHNP-BC, FNP-BC
Phone: 385-227-1209