Provider Demographics
NPI:1679718712
Name:SNYDER, DEBRA MOELLER (RN)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:MOELLER
Last Name:SNYDER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:59 MAIN STREET
Mailing Address - City:DRESDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14441-0217
Mailing Address - Country:US
Mailing Address - Phone:315-536-9553
Mailing Address - Fax:
Practice Address - Street 1:417 LIBERTY ST
Practice Address - Street 2:SUITE 2120
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-1100
Practice Address - Country:US
Practice Address - Phone:315-536-5160
Practice Address - Fax:315-536-5146
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22 3123142163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator