Provider Demographics
NPI:1083350516
Name:SNOW, CHRISTIE L (NP)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:L
Last Name:SNOW
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:L
Other - Last Name:CRUZ-VENTURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:90 VERMONT AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6478
Mailing Address - Country:US
Mailing Address - Phone:865-481-2541
Mailing Address - Fax:865-483-8151
Practice Address - Street 1:90 VERMONT AVE STE 300
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6478
Practice Address - Country:US
Practice Address - Phone:865-481-2541
Practice Address - Fax:865-483-8151
Is Sole Proprietor?:No
Enumeration Date:2022-05-09
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31420363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner