Provider Demographics
NPI:1578101499
Name:SNIDER, MERRY ANNA (DNP)
Entity Type:Individual
Prefix:
First Name:MERRY
Middle Name:ANNA
Last Name:SNIDER
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:MERRY
Other - Middle Name:ANNA
Other - Last Name:VARNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
Mailing Address - Street 1:30 SANDSTONE CIR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-2073
Mailing Address - Country:US
Mailing Address - Phone:731-240-1695
Mailing Address - Fax:
Practice Address - Street 1:629 NUCKOLLS RD
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:TN
Practice Address - Zip Code:38008-1599
Practice Address - Country:US
Practice Address - Phone:731-658-3388
Practice Address - Fax:731-658-4079
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26912363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health