=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396603205
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BROOKLYNE KAY SNIEGOCKI RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/12/2026
-----------------------------------------------------
Last Update Date | 01/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1500 WEISS ST
-----------------------------------------------------
City | SAGINAW
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48602-5251
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-497-2500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1228 HOLYROOD ST
-----------------------------------------------------
City | MIDLAND
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48640-6313
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-948-4513
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 4704289384
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------