Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 4704165997 | MI |
NPI | 1003034521 |
---|---|
Provider Name | Mrs. Kelly Ann Baird-Cox |
First Address | Canton, MI 48188-3245 |
Second Address | Holt, MI 48842-1000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2007 |
Last Update Date | 08/07/2007 |