Provider Demographics
NPI:1629086715
Name:SNEAD, LAURIE JOHNSTON (CNM)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:JOHNSTON
Last Name:SNEAD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4499 CAIN CIR
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-3102
Mailing Address - Country:US
Mailing Address - Phone:770-491-3547
Mailing Address - Fax:
Practice Address - Street 1:993 JOHNSON FERRY RD NE
Practice Address - Street 2:BLD D SUITE 360
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1620
Practice Address - Country:US
Practice Address - Phone:404-250-1350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAR5861367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife