Provider Demographics
NPI:1225097595
Name:SNYDER, KOLLEEN CARMICHAEL (ARNP, CFNP)
Entity Type:Individual
Prefix:
First Name:KOLLEEN
Middle Name:CARMICHAEL
Last Name:SNYDER
Suffix:
Gender:F
Credentials:ARNP, CFNP
Other - Prefix:
Other - First Name:KOLLEEN
Other - Middle Name:C
Other - Last Name:ARTIGUE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPN
Mailing Address - Street 1:PO BOX 282
Mailing Address - Street 2:
Mailing Address - City:KROTZ SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70750-0282
Mailing Address - Country:US
Mailing Address - Phone:337-948-3676
Mailing Address - Fax:337-943-7183
Practice Address - Street 1:539 E PRUDHOMME ST
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6499
Practice Address - Country:US
Practice Address - Phone:337-948-3676
Practice Address - Fax:337-943-7183
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04565363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner