Healthcare Provider Details

I. General information

NPI: 1033392360
Provider Name (Legal Business Name): NORMA JEAN SNELL BSN, RN, MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 12/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 INDUSTRIAL PARK RD
PLYMOUTH MA
02360-4881
US

IV. Provider business mailing address

14 JACKSON ST
PLYMOUTH MA
02360-5716
US

V. Phone/Fax

Practice location:
  • Phone: 508-747-2012
  • Fax:
Mailing address:
  • Phone: 508-759-7446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number168743
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: