Provider Demographics
NPI:1790755585
Name:BAIRD, KIM TIMMERMAN (FNP)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:TIMMERMAN
Last Name:BAIRD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 BEDELL AVE
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:GA
Mailing Address - Zip Code:31569-0308
Mailing Address - Country:US
Mailing Address - Phone:912-576-5999
Mailing Address - Fax:912-576-5888
Practice Address - Street 1:308 BEDELL AVE
Practice Address - Street 2:
Practice Address - City:WOODBINE
Practice Address - State:GA
Practice Address - Zip Code:31569-0307
Practice Address - Country:US
Practice Address - Phone:912-576-5999
Practice Address - Fax:912-576-5888
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAR051587363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00632673DMedicaid
GA00632673DMedicaid
GA50BBCSTMedicare ID - Type Unspecified