Healthcare Provider Details

I. General information

NPI: 1447075031
Provider Name (Legal Business Name): ASHLEY J SNYDER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11200 N 83RD AVE
PEORIA AZ
85345-5945
US

IV. Provider business mailing address

3302 N 7TH ST UNIT 310
PHOENIX AZ
85014-5491
US

V. Phone/Fax

Practice location:
  • Phone: 623-486-6300
  • Fax:
Mailing address:
  • Phone: 480-428-9110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN164646
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: