Healthcare Provider Details

I. General information

NPI: 1194380246
Provider Name (Legal Business Name): STEFANIE NICOLE SNEED CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2019
Last Update Date: 11/08/2025
Certification Date: 11/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6631 ATLANTA HWY
MONTGOMERY AL
36117-4233
US

IV. Provider business mailing address

6631 ATLANTA HWY
MONTGOMERY AL
36117-4233
US

V. Phone/Fax

Practice location:
  • Phone: 909-837-0545
  • Fax:
Mailing address:
  • Phone: 909-837-0545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN9399234
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WC3500X
TaxonomyCardiac Rehabilitation Registered Nurse
License NumberRN9399234
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number1-174612
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN9399234
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-174612
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: