Provider Demographics
NPI:1871067223
Name:BAIRD, CHEYENNE KIZZY (BSRT, RCP)
Entity type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:KIZZY
Last Name:BAIRD
Suffix:
Gender:F
Credentials:BSRT, RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 BANCROFT ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28206-3527
Mailing Address - Country:US
Mailing Address - Phone:347-729-4320
Mailing Address - Fax:
Practice Address - Street 1:2805 BANCROFT ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28206-3527
Practice Address - Country:US
Practice Address - Phone:347-729-4320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6121227900000X
6121227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered