Healthcare Provider Details

I. General information

NPI: 1457048860
Provider Name (Legal Business Name): ROBERT BAIRD NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

939 US-89 SUITE 1
LOGAN UT
84321-6581
US

IV. Provider business mailing address

467 W 1875 S APT D401
WOODS CROSS UT
84010-4179
US

V. Phone/Fax

Practice location:
  • Phone: 435-787-8504
  • Fax: 435-787-8509
Mailing address:
  • Phone: 385-227-1209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number53888
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5670596-4405
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number79057
License Number StateID
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53888
License Number StateWY
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5670596-4405
License Number StateUT
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number79057
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: