Provider Demographics
NPI:1972723195
Name:CHANEY, VONDA FAYE (MD)
Entity type:Individual
Prefix:
First Name:VONDA
Middle Name:FAYE
Last Name:CHANEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 AQUAHART DR
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21113
Mailing Address - Country:US
Mailing Address - Phone:410-222-6838
Mailing Address - Fax:410-222-6840
Practice Address - Street 1:719 AQUAHART RD
Practice Address - Street 2:3RD FLOOR, SCHOOL HEALTH SERVICES
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061
Practice Address - Country:US
Practice Address - Phone:410-222-6838
Practice Address - Fax:410-222-6840
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR163602163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool