Vonda J Baca, RN
Individual provider Active NPI Registered Nurse · Jemez Pueblo, NM
NPI 1801934864 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1801934864
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- R50136 (NM)
- Practice address
- 110 Sheepsprings Way St
Jemez Pueblo, NM 87024 - Phone
- (505) 834-7413
- NPI assigned
- Feb 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R50136 | NM | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R50136 | NM | Yes |
Addresses
Primary practice location
110 Sheepsprings Way St
Jemez Pueblo, NM 87024
Mailing address
231 Canal St
Jemez Pueblo, NM 87024
Other providers in Jemez Pueblo, NM
- Darlene J Armijo
- Christina Aulbach
- Mildred Baca
- Fallon Bader
- Brenda Barr
- Marlencia D Chee
- Alana Chinana
- Cheryl Renee Chinana
All providers in Jemez Pueblo, NM · Registered Nurse in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.