Healthcare Provider Details

I. General information

NPI: 1184902298
Provider Name (Legal Business Name): STEFANIE SNYDER R.N., CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2011
Last Update Date: 08/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 CROSSROADS RD SUITE 201
SCOTTDALE PA
15683-2458
US

IV. Provider business mailing address

109 CROSSROADS RD SUITE 201
SCOTTDALE PA
15683-2458
US

V. Phone/Fax

Practice location:
  • Phone: 724-887-3161
  • Fax: 724-887-3548
Mailing address:
  • Phone: 724-887-3161
  • Fax: 724-887-3548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN602401
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSPO11503
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: