1225097595 NPI number — KOLLEEN CARMICHAEL SNYDER ARNP, CFNP

Table of content: KOLLEEN CARMICHAEL SNYDER ARNP, CFNP (NPI 1225097595)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225097595 NPI number — KOLLEEN CARMICHAEL SNYDER ARNP, CFNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SNYDER
Provider First Name:
KOLLEEN
Provider Middle Name:
CARMICHAEL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP, CFNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ARTIGUE
Provider Other First Name:
KOLLEEN
Provider Other Middle Name:
C.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPN
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1225097595
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 282
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KROTZ SPRINGS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70750-0282
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-948-3676
Provider Business Mailing Address Fax Number:
337-943-7183

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
539 E PRUDHOMME ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OPELOUSAS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70570-6499
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-948-3676
Provider Business Practice Location Address Fax Number:
337-943-7183
Provider Enumeration Date:
03/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  AP04565 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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