MEDICARE: NICOLAS SNYDER PAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	4749	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154621381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLAS SNYDER PAC

Provider Business Mailing Address
First Line	:	4600 S MILL AVE
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-6757
Country	:	US
Telephone Number	:	480-305-2888
Fax Number	:	480-305-2889

Provider Business Practice Location Address
First Line	:	2640 W BASELINE RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-6492
Country	:	US
Telephone Number	:	480-677-8282
Fax Number	:	480-677-8283

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2010
Last Update Date	:	07/23/2015

Similar Medicare Providers

1598722530 — MS. SALLY A HARTZELL PA-C
Practice Location Address:

2640 W BASELINE RD STE 111
PHOENIX, AZ
85041-6492

Practice Phone: 480-677-8282
Practice Fax: 480-677-8283

1841216884 — KRISTEN THOMSEN MD
Practice Location Address:

2640 W BASELINE RD , STE 111
PHOENIX, AZ
85041-6492

Practice Phone: 480-677-8282
Practice Fax: 480-677-8283

1457407256 — AMY JEANNINE LENOX PA
Practice Location Address:

2640 W BASELINE RD , SUITE 111
PHOENIX, AZ
85041-6492

Practice Phone: 480-677-8282
Practice Fax: 480-677-8283

1306003678 — KARLA M LODGE PA-C
Practice Location Address:

2640 W BASELINE RD STE 111
PHOENIX, AZ
85041-6492

Practice Phone: 480-677-8282
Practice Fax: 888-316-1686

1982915237 — CRYSTAL ALSTON NP-C
Practice Location Address:

2640 W BASELINE RD STE 111
PHOENIX, AZ
85041-6492

Practice Phone: 480-677-8282
Practice Fax: 844-470-2777

1821376526 — WENDY LYNN RYNES NP
Practice Location Address:

2640 W BASELINE RD
PHOENIX, AZ
85041-6492

Practice Phone: 480-677-8282
Practice Fax: 480-677-8283

Directions to “ NICOLAS SNYDER PAC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.