Provider Demographics
NPI:1457568388
Name:BAIRD, JENNIFFERR LOUISE (RN)
Entity Type:Individual
Prefix:
First Name:JENNIFFERR
Middle Name:LOUISE
Last Name:BAIRD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73128-3025
Mailing Address - Country:US
Mailing Address - Phone:405-550-6008
Mailing Address - Fax:405-787-1018
Practice Address - Street 1:6801 NW 39TH EXPY
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-2501
Practice Address - Country:US
Practice Address - Phone:405-787-6772
Practice Address - Fax:405-787-1018
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0062880163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse