Healthcare Provider Details

I. General information

NPI: 1285239400
Provider Name (Legal Business Name): AMANDA NICOLE SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML7022
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE ML7022 CHILDRENS HOSPITAL MEDICAL CENTER
CINCINNATI OH
45229
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4531
  • Fax: 513-636-7407
Mailing address:
  • Phone: 513-636-4531
  • Fax: 513-636-7407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number202011902
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.381254
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0028158
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: