Healthcare Provider Details

I. General information

NPI: 1174221626
Provider Name (Legal Business Name): JAMES E SNYDER MS, FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2023
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 E MAIN ST STE G
JACKSON OH
45640-1788
US

IV. Provider business mailing address

22 N OHIO AVE
WELLSTON OH
45692-1230
US

V. Phone/Fax

Practice location:
  • Phone: 740-577-3043
  • Fax:
Mailing address:
  • Phone: 740-855-4511
  • Fax: 740-855-4533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0033327
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: