Healthcare Provider Details

I. General information

NPI: 1679770242
Provider Name (Legal Business Name): BEVERLY WARD SNAMAN RN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 HERITAGE WAY NE STE 302
LEESBURG VA
20176-4544
US

IV. Provider business mailing address

102 HERITAGE WAY NE STE 102
LEESBURG VA
20176-4544
US

V. Phone/Fax

Practice location:
  • Phone: 703-771-5100
  • Fax: 703-777-0170
Mailing address:
  • Phone: 703-771-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number0001119539
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: