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General NPI Number Information
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NPI Number | 1588620793
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Entity Type | Individual
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Provider Name | SHAWN SNIDER NP
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Gender | Male
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 08/24/2015
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Provider Practice Location Address
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Address Line | 880 TANGLEFOOT LN
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City | BETTENDORF
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State | IA
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Zip | 52722-1605
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Country | US
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Telephone | 309-285-8212
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Fax | 888-660-9460
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Provider Business Mailing Address
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Address Line | 880 TANGLEFOOT LN
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City | BETTENDORF
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State | IA
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Zip | 52722-1605
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Country | US
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Telephone | 309-285-8212
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Fax | 888-660-9460
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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 | 209005824
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License Number State | IL
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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 | A-128168
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 23734
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License Number State | CA
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