Healthcare Provider Details

I. General information

NPI: 1780407494
Provider Name (Legal Business Name): ROZALYN OSBORN SNYDER MSN-FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2024
Last Update Date: 11/02/2024
Certification Date: 11/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 HOLLY AVE NE # STUDIO14
ALBUQUERQUE NM
87113-2629
US

IV. Provider business mailing address

2525 VISTA LARGA AVE NE
ALBUQUERQUE NM
87106-2647
US

V. Phone/Fax

Practice location:
  • Phone: 505-377-4581
  • Fax:
Mailing address:
  • Phone: 773-495-2260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number64310
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: