Basic Information
| Provider Information | |||||||||
| NPI: | 1942670989 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAIRD | ||||||||
| FirstName: | JAN | ||||||||
| MiddleName: | C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 75 ARCH ST STE 407 | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443041433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303849001 | ||||||||
| FaxNumber: | 3303849002 | ||||||||
| Practice Location | |||||||||
| Address1: | 75 ARCH ST STE 407 | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443041433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303849001 | ||||||||
| FaxNumber: | 3303849002 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2015 | ||||||||
| LastUpdateDate: | 10/02/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SA2100X | COA.17987-NS | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Acute Care |
No ID Information.