Healthcare Provider Details

I. General information

NPI: 1578529699
Provider Name (Legal Business Name): ANGELA M SNYDER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 02/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 FOREST CIR SUITE 100
JONESBOROUGH TN
37659-1447
US

IV. Provider business mailing address

395 FOREST CIR SUITE 100
JONESBOROUGH TN
37659-1447
US

V. Phone/Fax

Practice location:
  • Phone: 423-753-0721
  • Fax: 423-753-0751
Mailing address:
  • Phone: 423-753-0721
  • Fax: 423-753-0751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN07502
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024169573
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: