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General NPI Number Information
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NPI Number | 1942152749
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Entity Type | Individual
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Provider Name | KELLIE SNYDER
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Gender | Female
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 09/22/2026
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Provider Practice Location Address
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Address Line | 560 W BROWN RD STE 1011
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City | MESA
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State | AZ
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Zip | 85201-3222
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Country | US
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Telephone | 360-280-5149
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Fax |
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Provider Business Mailing Address
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Address Line | 10121 E GAMMA AVE
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City | MESA
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State | AZ
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Zip | 85212-9221
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Country | US
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Telephone | 360-280-5149
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Fax |
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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 | 309482
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 309482
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License Number State | AZ
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