Healthcare Provider Details

I. General information

NPI: 1255137121
Provider Name (Legal Business Name): MS. STEPHANIE GRACE SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76141 ROAD 428
COZAD NE
69130-5314
US

IV. Provider business mailing address

76141 ROAD 428
COZAD NE
69130-5314
US

V. Phone/Fax

Practice location:
  • Phone: 308-784-4515
  • Fax:
Mailing address:
  • Phone: 308-784-4515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: