Provider Demographics
NPI:1962117614
Name:BAIRD, CARLISLE (FNP-C)
Entity type:Individual
Prefix:
First Name:CARLISLE
Middle Name:
Last Name:BAIRD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9030
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-9030
Mailing Address - Country:US
Mailing Address - Phone:940-264-2625
Mailing Address - Fax:940-264-6401
Practice Address - Street 1:4007 CALL FIELD RD STE E
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-2679
Practice Address - Country:US
Practice Address - Phone:940-264-2625
Practice Address - Fax:940-264-6401
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1140000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily