1225305758 NPI number — SUSAN KING BAIRD DNP, APRN, FNP-BC

NPI Number: 1225305758
Health Care Provider/Practitioner: SUSAN KING BAIRD DNP, APRN, FNP-BC

NPI Number : 1225305758 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1225305758",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BAIRD",
    "FirstName": "SUSAN",
    "MiddleName": "KING",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "DNP, APRN, FNP-BC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "KING",
    "OtherFirstName": "SUSAN",
    "OtherMiddleName": "G",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "CRNP",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "1511 N WUTHERING HILLS DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JANESVILLE",
    "MailingAddressStateName": "WI",
    "MailingAddressPostalCode": "53546-3407",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "814-335-2972",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3200 E RACINE ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JANESVILLE",
    "PracticeLocationAddressStateName": "WI",
    "PracticeLocationAddressPostalCode": "53546-2343",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "608-371-8000",
    "PracticeLocationAddressFaxNumber": "608-371-8938",
    "EnumerationDate": "11/29/2011",
    "LastUpdateDate": "05/30/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "192873-30",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "SP011662",
          "LicenseNumberStateCode": "PA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363L00000X",
          "TaxonomyName": "Nurse Practitioner",
          "LicenseNumber": "5045-33",
          "LicenseNumberStateCode": "WI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}