MEDICARE: DR. KIMBERLY KAY SNYDER PHARM D, RP

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	11770	NE

General Provider Information

NPI Number	:	1326104258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY KAY SNYDER PHARM D, RP

Provider Business Mailing Address
First Line	:	6400 WINTERBERRY LANE
Second Line	:
City	:	ROCA
State	:	NE
Zip	:	68430
Country	:	US
Telephone Number	:	402-525-1340
Fax Number	:

Provider Business Practice Location Address
First Line	:	6400 WINTERBERRY LANE
Second Line	:
City	:	ROCA
State	:	NE
Zip	:	68430
Country	:	US
Telephone Number	:	402-525-1340
Fax Number	:

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

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	01/03/2012

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