Healthcare Provider Details

I. General information

NPI: 1821541657
Provider Name (Legal Business Name): THERESSA K SNYDER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 07/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 N MAIN ST
NEW LEXINGTON OH
43764-1264
US

IV. Provider business mailing address

203 N MAIN ST
NEW LEXINGTON OH
43764-1264
US

V. Phone/Fax

Practice location:
  • Phone: 740-342-1991
  • Fax: 740-342-2914
Mailing address:
  • Phone: 740-342-1991
  • Fax: 740-342-2914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.367361
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: