Provider Demographics
NPI:1003034521
Name:BAIRD-COX, KELLY ANN (RN, MSN, CPNP)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:ANN
Last Name:BAIRD-COX
Suffix:
Gender:F
Credentials:RN, MSN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44733 FENWICK DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-3245
Mailing Address - Country:US
Mailing Address - Phone:734-394-2120
Mailing Address - Fax:
Practice Address - Street 1:4801 WILLOUGHBY RD
Practice Address - Street 2:SUITE 3
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-1000
Practice Address - Country:US
Practice Address - Phone:517-268-6627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704165997363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics