Healthcare Provider Details

I. General information

NPI: 1316809866
Provider Name (Legal Business Name): EMILY SNIEGOWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 S STATE ST
SHELBY MI
49455-1243
US

IV. Provider business mailing address

119 S STATE ST
SHELBY MI
49455-1243
US

V. Phone/Fax

Practice location:
  • Phone: 231-861-2130
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704389303
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: