Individual
MRS. KATHERINE MARIE BAIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
112 MANSFIELD AVE, WILLIMANTIC, CT 06226-2045
(860) 423-6410
Mailing address
PO BOX 414521, BOSTON, MA 02241-4521
(860) 423-6410
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001000790
NC
363A00000X
Physician Assistant
Primary
002902
CT
363A00000X
Physician Assistant
PA-591
AL
Other
Enumeration date
01/24/2007
Last updated
06/26/2015
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