MEDICARE: MARTHA JEANNE SNYDER FNP

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
1	363LF0000X	Family Nurse Practitioner	133370	TX

General Provider Information

NPI Number	:	1164942082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTHA JEANNE SNYDER FNP

Provider Business Mailing Address
First Line	:	1004 STONEBROOK DR
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-7561
Country	:	US
Telephone Number	:	469-989-7451
Fax Number	:

Provider Business Practice Location Address
First Line	:	1004 STONEBROOK DR
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-7561
Country	:	US
Telephone Number	:	682-382-2114
Fax Number	:	972-366-0243

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2017
Last Update Date	:	06/10/2026

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