Healthcare Provider Details

I. General information

NPI: 1609520915
Provider Name (Legal Business Name): HANNAH SNYDER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH ELIZABETH SMITH

II. Dates (important events)

Enumeration Date: 02/06/2022
Last Update Date: 02/06/2022
Certification Date: 02/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11800 SUNRISE VALLEY DR
RESTON VA
20191-5300
US

IV. Provider business mailing address

25509 VIA LABRADA
VALENCIA CA
91355-2733
US

V. Phone/Fax

Practice location:
  • Phone: 703-709-1114
  • Fax:
Mailing address:
  • Phone: 661-219-3444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: