Provider Demographics
NPI:1497331789
Name:SNODGRASS, ASPEN ELISE (FNP)
Entity Type:Individual
Prefix:
First Name:ASPEN
Middle Name:ELISE
Last Name:SNODGRASS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 NW SOUTH OUTER RD
Mailing Address - Street 2:STE 200
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015-3069
Mailing Address - Country:US
Mailing Address - Phone:888-256-3814
Mailing Address - Fax:888-256-9054
Practice Address - Street 1:1100 NW SOUTH OUTER RD STE 200
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-3069
Practice Address - Country:US
Practice Address - Phone:888-256-3514
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-18
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021009855363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily