Healthcare Provider Details

I. General information

NPI: 1215113428
Provider Name (Legal Business Name): GINA MARIE SNELLINGS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GINA MARIE JACOBS R.N.

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3913 MORTON DR
RICHMOND VA
23223-1287
US

IV. Provider business mailing address

PO BOX 1041
MECHANICSVILLE VA
23111-1041
US

V. Phone/Fax

Practice location:
  • Phone: 804-541-0196
  • Fax: 804-249-9132
Mailing address:
  • Phone: 804-541-0196
  • Fax: 804-249-9132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number0001082165
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: