# JEREMY JOSEPH BIRD

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1447586144
- **Gender:** Man
- **Credential:** PA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 53170 | CA | — |
| 363AS0400X | Surgical Physician Assistant | 200447 | LA | — |
| 363AS0400X | Surgical Physician Assistant | 53170 | CA | — |
| 363L00000X | Nurse Practitioner | 18833 | CA | Yes |
| 363L00000X | Nurse Practitioner | AP06311 | LA | — |

## Other

- **Enumeration date:** 10/30/2009
- **Last updated:** 08/30/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 01528549 | — | MS |
| 05 | — | 2133845 | — | LA |