Provider Demographics
NPI:1497090534
Name:SNYDER, LEDEEN (RN)
Entity Type:Individual
Prefix:
First Name:LEDEEN
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:RN
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 1054
Mailing Address - Street 2:
Mailing Address - City:BONNERS FERRY
Mailing Address - State:ID
Mailing Address - Zip Code:83805-1054
Mailing Address - Country:US
Mailing Address - Phone:208-360-8462
Mailing Address - Fax:
Practice Address - Street 1:556 CHUTE CANYON WAY
Practice Address - Street 2:
Practice Address - City:BONNERS FERRY
Practice Address - State:ID
Practice Address - Zip Code:83805-5219
Practice Address - Country:US
Practice Address - Phone:208-360-8462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-30
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home