Provider Demographics
NPI:1235187881
Name:SNYDER, PAMELA D (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:D
Last Name:SNYDER
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 MILAN RD
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-5846
Mailing Address - Country:US
Mailing Address - Phone:419-557-5052
Mailing Address - Fax:419-624-0513
Practice Address - Street 1:5420 MILAN RD
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-5846
Practice Address - Country:US
Practice Address - Phone:419-557-5052
Practice Address - Fax:419-624-0513
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.08459363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2630479Medicaid
OHSNNP20212Medicare ID - Type UnspecifiedOFFICE LOCATION 2
OHSNNP20213Medicare ID - Type UnspecifiedOFFICE LOCATION 3
OHQ62988Medicare UPIN