Provider Demographics
NPI:1710360607
Name:SNOOK, CYNTHIA (NP-C)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:SNOOK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:YORK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 N MAIN ST
Mailing Address - Street 2:STE 1360
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45423-1021
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40 N MAIN ST
Practice Address - Street 2:STE 1360
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45423-1021
Practice Address - Country:US
Practice Address - Phone:937-252-2003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.17568-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily