Healthcare Provider Details

I. General information

NPI: 1700110186
Provider Name (Legal Business Name): BELLA AMY SNAPP PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMY RENE MONDS

II. Dates (important events)

Enumeration Date: 10/01/2009
Last Update Date: 09/02/2020
Certification Date: 09/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 W STONE DR
KINGSPORT TN
37660
US

IV. Provider business mailing address

1420 W STONE DR
KINGSPORT TN
37660
US

V. Phone/Fax

Practice location:
  • Phone: 423-246-3551
  • Fax: 423-246-3939
Mailing address:
  • Phone: 423-246-3551
  • Fax: 423-246-3939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19031
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number38941
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: