Healthcare Provider Details

I. General information

NPI: 1508329780
Provider Name (Legal Business Name): SAMANTHA SNOWDEN MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2019
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

569 HEALTH BLVD STE A
DAYTONA BEACH FL
32114-1499
US

IV. Provider business mailing address

569 HEALTH BLVD STE A
DAYTONA BEACH FL
32114-1499
US

V. Phone/Fax

Practice location:
  • Phone: 386-846-6568
  • Fax: 386-515-8235
Mailing address:
  • Phone: 386-290-6784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11002095
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: