Healthcare Provider Details

I. General information

NPI: 1952982241
Provider Name (Legal Business Name): LYNETTE SNYDER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 04/19/2021
Certification Date: 04/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 HUNTER LN
CAMP HILL PA
17011-2499
US

IV. Provider business mailing address

30 HUNTER LN
CAMP HILL PA
17011-2499
US

V. Phone/Fax

Practice location:
  • Phone: 324-380-0748
  • Fax:
Mailing address:
  • Phone: 800-748-3243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN575736
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: