Provider Demographics
NPI:1114007622
Name:SNIDER, MELINDA LOU (RNP)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:LOU
Last Name:SNIDER
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5214 HIGHWAY 36 W
Mailing Address - Street 2:
Mailing Address - City:ROSE BUD
Mailing Address - State:AR
Mailing Address - Zip Code:72137-9700
Mailing Address - Country:US
Mailing Address - Phone:501-940-6420
Mailing Address - Fax:
Practice Address - Street 1:112 BRANTLEY RD
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-8315
Practice Address - Country:US
Practice Address - Phone:501-268-6102
Practice Address - Fax:501-268-4445
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR900501363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health