Provider Demographics
NPI:1346206380
Name:SNYDER, GLENDA G (NP)
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:G
Last Name:SNYDER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 919
Mailing Address - Street 2:
Mailing Address - City:PICKENS
Mailing Address - State:SC
Mailing Address - Zip Code:29671-0919
Mailing Address - Country:US
Mailing Address - Phone:864-897-8286
Mailing Address - Fax:864-878-0035
Practice Address - Street 1:123 WG ACKER DR STE B
Practice Address - Street 2:
Practice Address - City:PICKENS
Practice Address - State:SC
Practice Address - Zip Code:29671-2739
Practice Address - Country:US
Practice Address - Phone:864-878-2435
Practice Address - Fax:864-898-1055
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN2299363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3988Medicaid
SCNP0862Medicaid
SCNP0862Medicaid
S546519342Medicare PIN
S546518065Medicare PIN
SC5664Medicare PIN