Healthcare Provider Details

I. General information

NPI: 1760241855
Provider Name (Legal Business Name): SANTANNA SNEED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W LEAKE ST
CLINTON MS
39056-4253
US

IV. Provider business mailing address

1755 LELIA DR
JACKSON MS
39216-4828
US

V. Phone/Fax

Practice location:
  • Phone: 601-397-9373
  • Fax:
Mailing address:
  • Phone: 601-397-9373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: