Provider Demographics
NPI:1174978845
Name:BAIRD, JESSICA MICHELLE (FNP-C)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:MICHELLE
Last Name:BAIRD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:JESSICA
Other - Middle Name:MICHELLE
Other - Last Name:SORENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3976 W FARRELL LN
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-4672
Mailing Address - Country:US
Mailing Address - Phone:801-414-7918
Mailing Address - Fax:
Practice Address - Street 1:3976 W FARRELL LN
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-4672
Practice Address - Country:US
Practice Address - Phone:801-414-7918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8282806-4405363LF0000X
UT8282806-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse