Provider Demographics
NPI:1235196817
Name:BAIRD, MARTHA (ARNP)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:BAIRD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 674
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66201-0674
Mailing Address - Country:US
Mailing Address - Phone:913-248-9693
Mailing Address - Fax:913-248-9383
Practice Address - Street 1:8629 BLUEJACKET ST
Practice Address - Street 2:SUITE 102
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66214-1604
Practice Address - Country:US
Practice Address - Phone:913-677-0500
Practice Address - Fax:913-677-5243
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS74237363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100291550CMedicaid
P48154Medicare UPIN