Provider Demographics
NPI:1366481194
Name:SNYDER-PETROWITZ, BETH ANN (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ANN
Last Name:SNYDER-PETROWITZ
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6043 DAWN AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5601
Mailing Address - Country:US
Mailing Address - Phone:517-388-1256
Mailing Address - Fax:
Practice Address - Street 1:805 S. OAKLAND
Practice Address - Street 2:
Practice Address - City:ST. JOHN'S
Practice Address - State:MI
Practice Address - Zip Code:48879
Practice Address - Country:US
Practice Address - Phone:989-224-6881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2016-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704179131367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered