Healthcare Provider Details

I. General information

NPI: 1144422692
Provider Name (Legal Business Name): KIMBERLY KAROL SNYDER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 06/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 DIPLOMACY DR
ANCHORAGE AK
99508-5926
US

IV. Provider business mailing address

10761 NW 4TH ST
PLANTATION FL
33324-1515
US

V. Phone/Fax

Practice location:
  • Phone: 907-729-1973
  • Fax:
Mailing address:
  • Phone: 406-399-2249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9200245
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number34336
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: