Healthcare Provider Details

I. General information

NPI: 1821005158
Provider Name (Legal Business Name): MELISSA J. SNYDER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 TERRY REILEY WAY
POTTSVILLE PA
17901-1774
US

IV. Provider business mailing address

100 N ACADEMY AVE
DANVILLE PA
17822-3034
US

V. Phone/Fax

Practice location:
  • Phone: 570-624-4444
  • Fax: 570-624-4445
Mailing address:
  • Phone: 570-271-6144
  • Fax: 570-271-6578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberVP004719B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: