Healthcare Provider Details

I. General information

NPI: 1730663097
Provider Name (Legal Business Name): LANA SNYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2018
Last Update Date: 09/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4949 LIBERTY LN STE 210
ALLENTOWN PA
18106-9063
US

IV. Provider business mailing address

4949 LIBERTY LN STE 210
ALLENTOWN PA
18106-9063
US

V. Phone/Fax

Practice location:
  • Phone: 610-966-2676
  • Fax:
Mailing address:
  • Phone: 610-966-2676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN518766L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: