Healthcare Provider Details

I. General information

NPI: 1114952827
Provider Name (Legal Business Name): DONNA L SNYDER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 06/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 BROWNS HILL CT
MIDLOTHIAN VA
23114
US

IV. Provider business mailing address

360 BROWNS HILL CT
MIDLOTHIAN VA
23114-9500
US

V. Phone/Fax

Practice location:
  • Phone: 804-379-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024164872
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: