Provider Demographics
NPI:1407899065
Name:BAIRD, BARBARA JANE (APN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JANE
Last Name:BAIRD
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 DAVIS LN
Mailing Address - Street 2:
Mailing Address - City:LA FOLLETTE
Mailing Address - State:TN
Mailing Address - Zip Code:37766-3118
Mailing Address - Country:US
Mailing Address - Phone:423-562-0760
Mailing Address - Fax:
Practice Address - Street 1:136 DAVIS LN
Practice Address - Street 2:
Practice Address - City:LA FOLLETTE
Practice Address - State:TN
Practice Address - Zip Code:37766-3118
Practice Address - Country:US
Practice Address - Phone:423-562-0760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5663363LF0000X
TNAPN0000005663363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN33450002OtherPTAN
TN3345009Medicaid
TN33450002OtherPTAN
TN103I507033Medicare PIN
TN3345000Medicare ID - Type UnspecifiedMEDICARE
TN3345009Medicaid