Healthcare Provider Details

I. General information

NPI: 1538282215
Provider Name (Legal Business Name): CAROL D SNYDER LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1544 ROUTE 7
PIERPONT OH
44082-0078
US

IV. Provider business mailing address

PO BOX 78
PIERPONT OH
44082-0078
US

V. Phone/Fax

Practice location:
  • Phone: 440-577-1579
  • Fax:
Mailing address:
  • Phone: 440-577-1579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN.080893
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: