MEDICARE: BARBARA BAIRD RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	111776-RN	OH

General Provider Information

NPI Number	:	1174585566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA BAIRD RN

Provider Business Mailing Address
First Line	:	1645 COUNTY ROUTE 15
Second Line	:
City	:	RAYLAND
State	:	OH
Zip	:	43943-9774
Country	:	US
Telephone Number	:	740-317-4082
Fax Number	:

Provider Business Practice Location Address
First Line	:	USA MEDDAC
Second Line	:	BOX 105109
City	:	FORT IRWIN
State	:	CA
Zip	:	92310-5109
Country	:	US
Telephone Number	:	760-380-3234
Fax Number	:	760-380-5861

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	07/08/2007

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