Provider Demographics
NPI:1083855340
Name:SNYDER, MISTY MARIE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:MARIE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 GLENWOOD DR
Mailing Address - Street 2:201
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3315
Mailing Address - Country:US
Mailing Address - Phone:407-740-5127
Mailing Address - Fax:407-740-0827
Practice Address - Street 1:2200 GLENWOOD DR
Practice Address - Street 2:201
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3315
Practice Address - Country:US
Practice Address - Phone:407-740-5127
Practice Address - Fax:407-740-0827
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9169351363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health