Healthcare Provider Details

I. General information

NPI: 1790650612
Provider Name (Legal Business Name): KARLIE ANN SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S BALTIMORE ST
KIRKSVILLE MO
63501-3749
US

IV. Provider business mailing address

101 S BALTIMORE ST
KIRKSVILLE MO
63501-3749
US

V. Phone/Fax

Practice location:
  • Phone: 660-665-9114
  • Fax: 573-756-0505
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2025044243
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: