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NPI Code Detail

MEDICARE: MS. KATRINA LATRICE SNIDER PMHNP - BC

MEDICARE: MS. KATRINA LATRICE SNIDER PMHNP - BC
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
1163W00000XRegistered NurseRN255430GA
2163W00000XRegistered NurseRN9341570FL
3163W00000XRegistered Nurse258977NC
4363LP0808XPsychiatric/Mental Health Nurse PractitionerRN255430GA

General Provider Information

NPI Number : 1366894867
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATRINA LATRICE SNIDER PMHNP - BC
Provider Business Mailing Address
First Line : 240 MITCHELL BRIDGE RD
Second Line :
City : ATHENS
State : GA
Zip : 30606-2043
Country : US
Telephone Number : 561-844-2379
Fax Number :
Provider Business Practice Location Address
First Line : 240 MITCHELL BRIDGE RD
Second Line :
City : ATHENS
State : GA
Zip : 30606-2043
Country : US
Telephone Number : 706-369-6363
Fax Number : 706-389-6740
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2016
Last Update Date : 12/30/2019

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