Provider Demographics
NPI:1386772424
Name:BAKER, VONDA ELAINE (PMHNP/RN)
Entity type:Individual
Prefix:
First Name:VONDA
Middle Name:ELAINE
Last Name:BAKER
Suffix:
Gender:F
Credentials:PMHNP/RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 SAINT FRANCIS ST APT 206
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-6248
Mailing Address - Country:US
Mailing Address - Phone:276-219-8371
Mailing Address - Fax:
Practice Address - Street 1:8221 WILLOW OAKS CORPORATE DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4512
Practice Address - Country:US
Practice Address - Phone:703-383-8500
Practice Address - Fax:703-653-7040
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
VA0024193439363LP0808X
VA0001179627163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No163W00000XNursing Service ProvidersRegistered Nurse