Provider Demographics
NPI:1184818817
Name:SNOW, TWANA LYN (APRN)
Entity Type:Individual
Prefix:
First Name:TWANA
Middle Name:LYN
Last Name:SNOW
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TWANA
Other - Middle Name:LYN
Other - Last Name:MCVICKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 10970
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33733-0970
Mailing Address - Country:US
Mailing Address - Phone:727-327-7656
Mailing Address - Fax:727-322-2110
Practice Address - Street 1:4010 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33711-1239
Practice Address - Country:US
Practice Address - Phone:727-327-7656
Practice Address - Fax:727-322-2110
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX602109364SP0808X
FLARNP9491251363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health