Healthcare Provider Details

I. General information

NPI: 1578515805
Provider Name (Legal Business Name): SHEILA R SNIDOW A.P.R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 09/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

756 ATHENS RD
PRINCETON WV
24740-6261
US

IV. Provider business mailing address

PO BOX 457 200 POCAHONTAS TRAIL
WHITE SULPHUR SPRINGS WV
24986-0457
US

V. Phone/Fax

Practice location:
  • Phone: 304-425-0716
  • Fax: 304-487-1322
Mailing address:
  • Phone: 304-536-5030
  • Fax: 304-536-5031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number45578
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: