Provider Demographics
NPI:1558744631
Name:SNYDER, LINDSAY B (APRN)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:B
Last Name:SNYDER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:B
Other - Last Name:HENCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:4010 W 65TH ST
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-1706
Mailing Address - Country:US
Mailing Address - Phone:952-456-7000
Mailing Address - Fax:952-456-7001
Practice Address - Street 1:4010 W 65TH ST
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-1706
Practice Address - Country:US
Practice Address - Phone:952-456-7000
Practice Address - Fax:952-456-7001
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1748578163W00000X
MNCNP 4036363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1558744631Medicaid
MNH400370976Medicare PIN