Provider Demographics
NPI:1639949290
Name:SNYDER, SHANNON JOYCE
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:JOYCE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:378 CHOICE CT
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-2935
Mailing Address - Country:US
Mailing Address - Phone:443-789-9747
Mailing Address - Fax:
Practice Address - Street 1:378 CHOICE CT
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-2935
Practice Address - Country:US
Practice Address - Phone:443-789-9747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant