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General NPI Number Information
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NPI Number | 1619221371
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Entity Type | Individual
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Provider Name | STEPHANIE MICHELLE BAIRD RPH
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Gender | Female
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Dates
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Enumeration Date | 11/02/2012
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Last Update Date | 12/14/2020
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Provider Practice Location Address
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Address Line | 1105 E GRAND AVE
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City | ROTHSCHILD
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State | WI
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Zip | 54474-1024
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Country | US
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Telephone | 715-359-4252
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Fax |
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Provider Business Mailing Address
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Address Line | 205 CENTRAL BRIDGE ST
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City | WAUSAU
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State | WI
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Zip | 54401-2947
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Country | US
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Telephone | 715-409-3015
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 12444-40
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | WI12444
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License Number State | WI
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