Provider Demographics
NPI:1710030051
Name:SNYDER, NANCY KATHERINE (RPH)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:KATHERINE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4108 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:SELLERSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47172-1760
Mailing Address - Country:US
Mailing Address - Phone:812-248-7377
Mailing Address - Fax:
Practice Address - Street 1:1125 VETERANS PKWY
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-2371
Practice Address - Country:US
Practice Address - Phone:812-284-5139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012315183500000X
IN26014845A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist