Healthcare Provider Details

I. General information

NPI: 1104452028
Provider Name (Legal Business Name): KARLINE PAIGE SNYDER MS, CNM, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2020
Last Update Date: 03/23/2020
Certification Date: 03/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9930 W INDIAN SCHOOL RD
PHOENIX AZ
85037-5902
US

IV. Provider business mailing address

1645 WESTRIDGE DR
CASPER WY
82604-3343
US

V. Phone/Fax

Practice location:
  • Phone: 623-846-7558
  • Fax:
Mailing address:
  • Phone: 307-751-4525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number239677
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: