Provider Demographics
NPI:1649394743
Name:FORS, GRETTA SNYDER (BSN, MSN, RN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:GRETTA
Middle Name:SNYDER
Last Name:FORS
Suffix:
Gender:F
Credentials:BSN, MSN, RN, NP-C
Other - Prefix:
Other - First Name:GRETCHEN
Other - Middle Name:HUFF
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:974 E 620 N
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-2004
Mailing Address - Country:US
Mailing Address - Phone:626-628-5037
Mailing Address - Fax:
Practice Address - Street 1:1750 NORTH WYMOUNT TERRACE DRIVE
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84602-4800
Practice Address - Country:US
Practice Address - Phone:801-422-2771
Practice Address - Fax:801-422-0764
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 15425363LF0000X
UT360925-8900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily