Provider Demographics
NPI:1164101531
Name:GABEL-BAIRD, TREVOR (DNP, FNP-C)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:GABEL-BAIRD
Suffix:
Gender:M
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:TREVOR
Other - Middle Name:
Other - Last Name:BAIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4976 WESCOTT BLVD APT 1227
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-9071
Mailing Address - Country:US
Mailing Address - Phone:803-528-4692
Mailing Address - Fax:
Practice Address - Street 1:6296 RIVERS AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-4903
Practice Address - Country:US
Practice Address - Phone:843-266-3870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27489363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily