Provider Demographics
NPI:1447544846
Name:BAKER, SHENEKIA M (RVT)
Entity type:Individual
Prefix:
First Name:SHENEKIA
Middle Name:M
Last Name:BAKER
Suffix:
Gender:F
Credentials:RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4772 EUCLID RD STE D
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3800
Mailing Address - Country:US
Mailing Address - Phone:757-685-7232
Mailing Address - Fax:
Practice Address - Street 1:4772 EUCLID RD STE D
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3800
Practice Address - Country:US
Practice Address - Phone:757-685-7232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1271572471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography