Bird, Keisha R.

Bird, Keisha R. is an individual health care provider with primary practice located at 807 Childrens Way , Jacksonville FL 32207-8426. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Bird, Keisha R. can be contacted via phone (904) 390-3759.

Contact Information

Primary practice address
807 Childrens Way Jacksonville FL 32207-8426
Phone: (904) 390-3759
Fax: (904) 390-3429
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X ARNP 9195075 Florida
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X ARNP 9195075 Florida

Profile Details

NPI number 1265523286
LBN Legal business name Bird, Keisha R.
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2006
Last updated Nov 21st, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265523286 NPPES
Georgia MEDICAID 104862505A
Georgia MEDICAID 305157900

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