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General NPI Number Information
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NPI Number | 1003272386
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Entity Type | Organization
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Legal Business Name | TEDDIE JOE SNODGRASS, INC.
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Dates
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Enumeration Date | 01/03/2016
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Last Update Date | 01/05/2023
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Provider Practice Location Address
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Address Line | 1130 N NIMITZ HWY RM A153
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City | HONOLULU
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State | HI
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Zip | 96817-5777
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Country | US
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Telephone | 808-342-7843
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Fax | 866-323-1118
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Provider Business Mailing Address
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Address Line | 105 FALLING ROCK RD
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City | SALTVILLE
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State | VA
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Zip | 24370-3577
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Country | US
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Telephone | 808-342-7843
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Fax | 866-323-1118
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TEDDIE JOE SNODGRASS
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Credential | FNP-BC, DNP
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Telephone | 808-342-7843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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