Healthcare Provider Details

I. General information

NPI: 1932343456
Provider Name (Legal Business Name): DAWN M SNYDER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 04/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12501 WILLOWBROOK RD 3RD FLOOR
CUMBERLAND MD
21502-2569
US

IV. Provider business mailing address

RR 2 BOX 284
FORT ASHBY WV
26719-9223
US

V. Phone/Fax

Practice location:
  • Phone: 301-723-1614
  • Fax: 301-723-1480
Mailing address:
  • Phone: 304-298-4250
  • Fax: 301-723-1480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2008004293
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number48572
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: