Healthcare Provider Details

I. General information

NPI: 1053994046
Provider Name (Legal Business Name): CHAISON SNYDER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2021
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 W 12TH AVE
DENVER CO
80204-3412
US

IV. Provider business mailing address

1600 W 12TH AVE
DENVER CO
80204-3412
US

V. Phone/Fax

Practice location:
  • Phone: 303-628-6868
  • Fax:
Mailing address:
  • Phone: 303-628-6868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0008152
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: