Provider Demographics
NPI:1427659010
Name:BAKER, ANGELA MARIE (FNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIE
Last Name:BAKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 CHARLES H DIMMOCK PKWY
Mailing Address - Street 2:STE 100
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-2990
Mailing Address - Country:US
Mailing Address - Phone:757-234-1648
Mailing Address - Fax:
Practice Address - Street 1:445 CHARLES H DIMMOCK PKWY
Practice Address - Street 2:STE 100
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-2990
Practice Address - Country:US
Practice Address - Phone:804-520-1764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily