Organization
MILLENNIUM 25 GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRAVIS ALDEN BAIRD CRNP (PRESIDENT)
(917) 873-5716
Entity
Organization
Contact information
Practice address
672 OLD MILL RD STE I, MILLERSVILLE, MD 21108-1363
(410) 729-0630
(410) 729-0091
Mailing address
8775 CENTRE PARK DR STE 251, COLUMBIA, MD 21045-2177
(917) 873-5716
(410) 729-0091
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/06/2021
Last updated
04/15/2021
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