Healthcare Provider Details

I. General information

NPI: 1477816775
Provider Name (Legal Business Name): ERIC CHARLES SNYDER CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 06/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1341 CLARK ST
CAMBRIDGE OH
43725-9614
US

IV. Provider business mailing address

10383 TWIN OAKS DR
CAMBRIDGE OH
43725-9274
US

V. Phone/Fax

Practice location:
  • Phone: 740-439-3561
  • Fax:
Mailing address:
  • Phone: 740-260-0589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number301838
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: