Healthcare Provider Details

I. General information

NPI: 1336281468
Provider Name (Legal Business Name): PAULA SUZANNE SNYDER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 04/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4351 E LOHMAN AVE SUITE 301
LAS CRUCES NM
88011-8259
US

IV. Provider business mailing address

4351 E LOHMAN AVE SUITE 301
LAS CRUCES NM
88011-8259
US

V. Phone/Fax

Practice location:
  • Phone: 575-532-8900
  • Fax: 575-532-8963
Mailing address:
  • Phone: 575-532-8900
  • Fax: 575-532-8963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2005-0050
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: