Healthcare Provider Details

I. General information

NPI: 1043140791
Provider Name (Legal Business Name): TAYLOR JO SNYDER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 MONTGOMERY ST
DECORAH IA
52101-2364
US

IV. Provider business mailing address

603 DAY ST
DECORAH IA
52101-2222
US

V. Phone/Fax

Practice location:
  • Phone: 563-382-2911
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number170228
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: