Provider Demographics
NPI:1114682580
Name:SNOW, NANCY E (FNP-BC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:E
Last Name:SNOW
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5933 NE WIN SIVERS DR STE 310
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-9106
Mailing Address - Country:US
Mailing Address - Phone:503-420-5852
Mailing Address - Fax:844-276-4208
Practice Address - Street 1:5933 NE WIN SIVERS DR STE 310
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-9106
Practice Address - Country:US
Practice Address - Phone:503-420-5852
Practice Address - Fax:844-276-4208
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202112481NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily