Individual
STACEY L MERRITT BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
6923 COLBURN DR, ANNANDALE, VA 22003-6107
(571) 730-0332
Mailing address
6923 COLBURN DR, ANNANDALE, VA 22003-6107
(571) 730-0332
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN1007058
DC
Other
Enumeration date
12/09/2006
Last updated
05/30/2016
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