Provider Demographics
NPI:1598723793
Name:BAIRD, JUDITH E (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:E
Last Name:BAIRD
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:103 SOLANA RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-2231
Mailing Address - Country:US
Mailing Address - Phone:904-273-2717
Mailing Address - Fax:904-273-0410
Practice Address - Street 1:103 SOLANA RD
Practice Address - Street 2:STE B
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-2231
Practice Address - Country:US
Practice Address - Phone:904-273-2717
Practice Address - Fax:904-273-0410
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2014-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA2142363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant