Provider Demographics
NPI:1851914337
Name:BAIRD, KANDICE (DEM)
Entity Type:Individual
Prefix:
First Name:KANDICE
Middle Name:
Last Name:BAIRD
Suffix:
Gender:F
Credentials:DEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 N 1285 E
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84040-3619
Mailing Address - Country:US
Mailing Address - Phone:801-928-0096
Mailing Address - Fax:
Practice Address - Street 1:627 N 1285 E
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84040-3619
Practice Address - Country:US
Practice Address - Phone:801-928-0096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay