Provider Demographics
NPI:1407502560
Name:SNOW, COLETTE MICHELINE (CRNA)
Entity Type:Individual
Prefix:DR
First Name:COLETTE
Middle Name:MICHELINE
Last Name:SNOW
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:COLETTE
Other - Middle Name:MICHELINE
Other - Last Name:MONTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6410 NORDIX DR
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20187-4440
Mailing Address - Country:US
Mailing Address - Phone:540-270-9920
Mailing Address - Fax:
Practice Address - Street 1:1001 SAM PERRY BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4453
Practice Address - Country:US
Practice Address - Phone:540-741-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-28
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024183769363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner