Provider Demographics
NPI:1871818468
Name:BAIER, KIMBERLY JILL (CRNA)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:JILL
Last Name:BAIER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3196 MCKEE RD
Mailing Address - Street 2:
Mailing Address - City:UPATOI
Mailing Address - State:GA
Mailing Address - Zip Code:31829-1752
Mailing Address - Country:US
Mailing Address - Phone:706-888-8763
Mailing Address - Fax:
Practice Address - Street 1:616 19TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1528
Practice Address - Country:US
Practice Address - Phone:706-494-4262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN171107367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered