Provider Demographics
NPI:1942670989
Name:BAIRD, JAN C
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:C
Last Name:BAIRD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 ARCH ST STE 407
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1433
Mailing Address - Country:US
Mailing Address - Phone:330-384-9001
Mailing Address - Fax:330-384-9002
Practice Address - Street 1:75 ARCH ST STE 407
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1433
Practice Address - Country:US
Practice Address - Phone:330-384-9001
Practice Address - Fax:330-384-9002
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.17987-NS364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care