MEDICARE: JUSTIN WAYNE SNIPES FNP

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	363LF0000X	Family Nurse Practitioner	F0608042	NC
2	207Q00000X	Family Medicine Physician	5004030	NC
3	363L00000X	Nurse Practitioner	5004030	NC

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
2	5004030	OTHER	NC	FNP LICENSE

General Provider Information

NPI Number	:	1275799967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN WAYNE SNIPES FNP

Provider Business Mailing Address
First Line	:	602 MORGANTON BLVD SW
Second Line	:
City	:	LENOIR
State	:	NC
Zip	:	28645-5823
Country	:	US
Telephone Number	:	828-239-9400
Fax Number	:	833-449-4125

Provider Business Practice Location Address
First Line	:	150 AUGUST ST STE 200
Second Line	:
City	:	MORGANTON
State	:	NC
Zip	:	28655-5898
Country	:	US
Telephone Number	:	828-218-4212
Fax Number	:	833-449-4125

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

Provider Enumeration Date	:	08/01/2008
Last Update Date	:	02/24/2026

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Directions to “ JUSTIN WAYNE SNIPES FNP” Practice Location

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