Healthcare Provider Details

I. General information

NPI: 1578061289
Provider Name (Legal Business Name): PATRICIA SNYDER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICIA SNYDER CHENOWETH SNYDER

II. Dates (important events)

Enumeration Date: 01/28/2018
Last Update Date: 08/23/2025
Certification Date: 08/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10120 E OLD VAIL RD STE 100
TUCSON AZ
85747-9414
US

IV. Provider business mailing address

10120 E OLD VAIL RD STE 100
TUCSON AZ
85747-9414
US

V. Phone/Fax

Practice location:
  • Phone: 520-989-8012
  • Fax: 520-989-8014
Mailing address:
  • Phone: 520-989-8012
  • Fax: 520-989-8014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28233062A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: