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General NPI Number Information
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NPI Number | 1053021717
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Entity Type | Individual
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Provider Name | MICHELLE L SNYDER FNP
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Gender | Female
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Dates
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Enumeration Date | 12/02/2022
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Last Update Date | 06/12/2024
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Provider Practice Location Address
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Address Line | 152 MEMORIAL CT
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City | JACKSONVILLE
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State | NC
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Zip | 28546-6322
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Country | US
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Telephone | 910-346-3976
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Fax | 910-353-0600
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Provider Business Mailing Address
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Address Line | PO BOX 986513 DEPT 100
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City | BOSTON
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State | MA
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Zip | 02298-6513
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Country | US
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Telephone | 910-219-8326
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Fax | 910-939-4269
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5017314
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5017314
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License Number State | NC
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