Healthcare Provider Details

I. General information

NPI: 1003134412
Provider Name (Legal Business Name): LOU-ANN MARIE SNYDER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2010
Last Update Date: 04/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 N 4TH ST
ALLENTOWN PA
18102-1852
US

IV. Provider business mailing address

421 W CHEW STREET
ALLENTOWN PA
18102-3490
US

V. Phone/Fax

Practice location:
  • Phone: 610-663-3463
  • Fax: 610-606-4448
Mailing address:
  • Phone: 610-663-3463
  • Fax: 610-606-4448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP010747
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: