Provider Demographics
NPI:1811352081
Name:ALINE BAYARD NP-C
Entity type:Organization
Organization Name:ALINE BAYARD NP-C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP-C
Authorized Official - Prefix:MS
Authorized Official - First Name:ALINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYARD
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:678-466-9351
Mailing Address - Street 1:2187 HYSSOP WAY
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-7719
Mailing Address - Country:US
Mailing Address - Phone:678-466-9351
Mailing Address - Fax:
Practice Address - Street 1:2187 HYSSOP WAY
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-7719
Practice Address - Country:US
Practice Address - Phone:678-466-9351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care