Healthcare Provider Details

I. General information

NPI: 1336719665
Provider Name (Legal Business Name): CHELSEA NICOLE SNYDER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2021
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4191 INNSLAKE DR STE 211
GLEN ALLEN VA
23060-3324
US

IV. Provider business mailing address

4191 INNSLAKE DR STE 211
GLEN ALLEN VA
23060-3324
US

V. Phone/Fax

Practice location:
  • Phone: 804-303-9622
  • Fax: 804-716-4318
Mailing address:
  • Phone: 804-303-9622
  • Fax: 804-716-4318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024182313
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0001263369
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: