Healthcare Provider Details

I. General information

NPI: 1134114457
Provider Name (Legal Business Name): MARIA A SNUFFER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 HARPER RD
BECKLEY WV
25801-3357
US

IV. Provider business mailing address

L 2771
COLUMBUS OH
43260-0001
US

V. Phone/Fax

Practice location:
  • Phone: 800-277-8151
  • Fax:
Mailing address:
  • Phone: 800-277-8151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number57232
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: