Provider Demographics
NPI:1003343757
Name:SNYDER, JENNIFER (AGPCNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 ASHFORD LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7142
Mailing Address - Country:US
Mailing Address - Phone:330-472-8733
Mailing Address - Fax:
Practice Address - Street 1:621 ASHFORD LN
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-7142
Practice Address - Country:US
Practice Address - Phone:330-472-8733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-12
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC234805363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner