Healthcare Provider Details

I. General information

NPI: 1639609837
Provider Name (Legal Business Name): RACHEL W SNYDER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2017
Last Update Date: 07/21/2022
Certification Date: 11/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3533 SOUTHERN BLVD STE 2100
KETTERING OH
45429-1267
US

IV. Provider business mailing address

3533 SOUTHERN BLVD STE 2100
KETTERING OH
45429-1267
US

V. Phone/Fax

Practice location:
  • Phone: 937-395-8556
  • Fax: 937-395-6376
Mailing address:
  • Phone: 937-395-8556
  • Fax: 937-395-6376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.343994
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.021115
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: