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NPI Code Detail

MEDICARE: JACQUELINE SNOW RN

MEDICARE: JACQUELINE SNOW RN
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
1163W00000XRegistered Nurse787209-01NY

General Provider Information

NPI Number : 1700713344
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE SNOW RN
Provider Business Mailing Address
First Line : 6012 COUNTY FARM RD
Second Line :
City : BALLSTON SPA
State : NY
Zip : 12020-2251
Country : US
Telephone Number : 518-584-7460
Fax Number :
Provider Business Practice Location Address
First Line : 6012 COUNTY FARM RD
Second Line :
City : BALLSTON SPA
State : NY
Zip : 12020-2251
Country : US
Telephone Number : 518-584-7460
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2026
Last Update Date : 05/07/2026

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