Provider Demographics
NPI:1407248313
Name:SNIDER, EILEEN (ADN, BSN)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:SNIDER
Suffix:
Gender:F
Credentials:ADN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24819 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:KANSASVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53139-9770
Mailing Address - Country:US
Mailing Address - Phone:847-208-2899
Mailing Address - Fax:
Practice Address - Street 1:24819 WILSON ST
Practice Address - Street 2:
Practice Address - City:KANSASVILLE
Practice Address - State:WI
Practice Address - Zip Code:53139-9770
Practice Address - Country:US
Practice Address - Phone:847-208-2899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-02
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI168477163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health