Provider Demographics
NPI:1093065369
Name:SNYDER, WILLIAM S III (FNP)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:SNYDER
Suffix:III
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 FILMORE ST
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-2130
Mailing Address - Country:US
Mailing Address - Phone:407-538-9455
Mailing Address - Fax:
Practice Address - Street 1:812 FILMORE ST
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2130
Practice Address - Country:US
Practice Address - Phone:407-538-9455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA165567163W00000X
IAA165759363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse