Healthcare Provider Details

I. General information

NPI: 1720709967
Provider Name (Legal Business Name): ERIC ROBERT SNYDER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2022
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 N CAMPBELL AVE
TUCSON AZ
85719-4330
US

IV. Provider business mailing address

7430 N SILVERBELL RD UNIT 9308
TUCSON AZ
85743-0030
US

V. Phone/Fax

Practice location:
  • Phone: 623-243-3349
  • Fax:
Mailing address:
  • Phone: 623-243-3349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number324649
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number324649
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN204990
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: