Healthcare Provider Details

I. General information

NPI: 1356276240
Provider Name (Legal Business Name): JANNA SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1332 PROSPECT AVE
CARO MI
48723-9288
US

IV. Provider business mailing address

1532 W GILFORD RD
CARO MI
48723-1017
US

V. Phone/Fax

Practice location:
  • Phone: 989-673-6191
  • Fax:
Mailing address:
  • Phone: 989-798-2665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number4704434220
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: