Provider Demographics
NPI:1659731347
Name:BAIRD, LAUREN C (PAC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:C
Last Name:BAIRD
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 BRIARWOOD DR STE B
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-5497
Mailing Address - Country:US
Mailing Address - Phone:828-294-1116
Mailing Address - Fax:
Practice Address - Street 1:1940 BRIARWOOD DR STE B
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-5497
Practice Address - Country:US
Practice Address - Phone:828-294-1116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-24
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-06302363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1659731347Medicaid
NC1659731347Medicaid