Provider Demographics
NPI:1619220647
Name:LAIRD, ANNE MARIE (APNP,CNM)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:MARIE
Last Name:LAIRD
Suffix:
Gender:F
Credentials:APNP,CNM
Other - Prefix:MISS
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:MACGILLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:615 S NEW BALLAS RD STE 1400
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8221
Mailing Address - Country:US
Mailing Address - Phone:314-521-7955
Mailing Address - Fax:
Practice Address - Street 1:615 S NEW BALLAS RD STE 1400
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8221
Practice Address - Country:US
Practice Address - Phone:314-521-7955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023010753367A00000X
FLAPRN11021918367A00000X
WI148995-32367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CNM05210OtherAMERICAN MIDWIFERY CERTIFICATION