Provider Demographics
NPI:1578529699
Name:SNYDER, ANGELA M (FNP-C)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:SNYDER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 FOREST CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-1447
Mailing Address - Country:US
Mailing Address - Phone:423-753-0721
Mailing Address - Fax:423-753-0751
Practice Address - Street 1:395 FOREST CIR
Practice Address - Street 2:SUITE 100
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-1447
Practice Address - Country:US
Practice Address - Phone:423-753-0721
Practice Address - Fax:423-753-0751
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN07502363LF0000X
VA0024169573363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3901744Medicaid
VA1578529699Medicaid
TN500027877OtherRR MEDICARE
TN103I503733Medicare PIN
VAVV4282AMedicare PIN
VA1578529699Medicaid
TN3901744Medicaid