Healthcare Provider Details

I. General information

NPI: 1942715396
Provider Name (Legal Business Name): SUSAN SNYDER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2017
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10210 E 91ST ST
TULSA OK
74133-5834
US

IV. Provider business mailing address

10210 E 91ST ST
TULSA OK
74133-5834
US

V. Phone/Fax

Practice location:
  • Phone: 918-940-8500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number96417
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: