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General NPI Number Information
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NPI Number | 1972961068
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Entity Type | Individual
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Provider Name | ALINE BAYARD CNP
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Gender | Female
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Dates
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Enumeration Date | 02/03/2016
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Last Update Date | 09/02/2019
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Provider Practice Location Address
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Address Line | 80 B VETERANS BLVD
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City | ACOMA
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State | NM
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Zip | 87034
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Country | US
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Telephone | 505-552-5300
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Fax | 505-552-5490
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Provider Business Mailing Address
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Address Line | 6131 S NORCROSS TUCKER RD
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City | NORCROSS
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State | GA
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Zip | 30093-5536
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Country | US
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Telephone | 678-205-1959
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Fax | 770-552-7100
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN141931
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License Number State | GA
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