Provider Demographics
NPI:1770021107
Name:SNEPP, OLIVIA (NP)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:SNEPP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:
Other - Last Name:GRABER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4943 ROSEBUD LN
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-9226
Mailing Address - Country:US
Mailing Address - Phone:812-471-4302
Mailing Address - Fax:812-471-4303
Practice Address - Street 1:4943 ROSEBUD LN
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-9226
Practice Address - Country:US
Practice Address - Phone:812-471-4302
Practice Address - Fax:812-471-4303
Is Sole Proprietor?:No
Enumeration Date:2017-02-06
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28202525A163W00000X
IN71006886A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse