Healthcare Provider Details

I. General information

NPI: 1366571523
Provider Name (Legal Business Name): KIMBERLY JEAN SNYDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 01/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 GREENLEA BLVD STE E
GALLATIN TN
37066-3228
US

IV. Provider business mailing address

300 STEAM PLANT RD STE 300
GALLATIN TN
37066-3032
US

V. Phone/Fax

Practice location:
  • Phone: 615-575-0303
  • Fax: 615-989-4661
Mailing address:
  • Phone: 615-230-8070
  • Fax: 615-989-4661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number42806
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: