Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 40150 | CO |
NPI | 1013900539 |
---|---|
Provider Name | Dr. Kristin M Baird |
First Address | Longmont, CO 80501-6972 |
Second Address | Longmont, CO 80501-6972 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2005 |
Last Update Date | 10/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
58659099 | (05) | CO |
70016791 | RAILROAD MEDICARE (01) | CO |
H57526 | (02) | CO |