Healthcare Provider Details

I. General information

NPI: 1114498995
Provider Name (Legal Business Name): NICOLE SNAPPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2018
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 EAST AVE
PAWTUCKET RI
02860-4003
US

IV. Provider business mailing address

39 EAST AVE
PAWTUCKET RI
02860-4003
US

V. Phone/Fax

Practice location:
  • Phone: 401-722-0081
  • Fax: 401-729-9901
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN01991
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2318339
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: