Healthcare Provider Details

I. General information

NPI: 1104966605
Provider Name (Legal Business Name): ANITA M SNYDER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 WRIGHTS LN
WEST CHESTER PA
19380-4252
US

IV. Provider business mailing address

412 CREAMERY WAY SUITE 400
EXTON PA
19341-2551
US

V. Phone/Fax

Practice location:
  • Phone: 610-431-1210
  • Fax: 610-594-2625
Mailing address:
  • Phone: 610-594-7590
  • Fax: 610-594-7597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN333084L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP008405
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: