Healthcare Provider Details

I. General information

NPI: 1104956952
Provider Name (Legal Business Name): JULIE A SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 03/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 FRANKLIN ST
DENVER CO
80205-5437
US

IV. Provider business mailing address

3066 S TRENTON ST
DENVER CO
80231-4164
US

V. Phone/Fax

Practice location:
  • Phone: 303-764-5102
  • Fax:
Mailing address:
  • Phone: 720-308-5907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number163913
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number163913
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: