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General NPI Number Information
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NPI Number | 1497152458
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Entity Type | Individual
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Provider Name | DONNA DEMETRAL SNOW CNP
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Gender | Female
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Dates
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Enumeration Date | 11/19/2014
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Last Update Date | 11/25/2014
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Provider Practice Location Address
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Address Line | 701 NORTHSIDE DR
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City | NEWTON
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State | MS
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Zip | 39345-2361
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Country | US
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Telephone | 601-683-4300
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Fax | 601-683-4303
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Provider Business Mailing Address
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Address Line | 3972 BETHAL ROBERTS RD
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City | NEWTON
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State | MS
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Zip | 39345-3109
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Country | US
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Telephone | 601-683-3969
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Fax | 601-683-4303
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R863971
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License Number State | MS
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