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General NPI Number Information
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NPI Number | 1750508602
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Entity Type | Organization
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Legal Business Name | KIM T. BAIRD, FNP-CS
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Dates
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Enumeration Date | 04/20/2007
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 308 BEDELL AVE
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City | WOODBINE
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State | GA
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Zip | 31569-0308
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Country | US
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Telephone | 912-576-5999
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Fax | 912-576-5888
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Provider Business Mailing Address
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Address Line | PO BOX 307
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City | WOODBINE
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State | GA
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Zip | 31569-0307
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Country | US
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Telephone | 912-576-5999
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Fax | 912-576-5888
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DELORES HAMILTON
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Credential |
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Telephone | 912-576-5999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R051587
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License Number State | GA
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