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NPI Code Detail

MEDICARE: DESTINY RENEE BALDONI AGACNP-BC

MEDICARE: DESTINY RENEE BALDONI AGACNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse Practitioner0024185857VA
2163W00000XRegistered Nurse0001270234VA

General Provider Information

NPI Number : 1619688645
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESTINY RENEE BALDONI AGACNP-BC
Provider Business Mailing Address
First Line : 213 S JEFFERSON ST STE 1006
Second Line :
City : ROANOKE
State : VA
Zip : 24011-1713
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3 RIVERSIDE CIR
Second Line :
City : ROANOKE
State : VA
Zip : 24016-4955
Country : US
Telephone Number : 540-224-5170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2022
Last Update Date : 01/13/2026

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Directions to “ DESTINY RENEE BALDONI AGACNP-BC” Practice Location

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