Provider Demographics
NPI:1821272923
Name:SNODGRASS, TEDDIE JOE (DNP, FNP-C)
Entity Type:Individual
Prefix:DR
First Name:TEDDIE
Middle Name:JOE
Last Name:SNODGRASS
Suffix:
Gender:M
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 FALLING ROCK RD
Mailing Address - Street 2:
Mailing Address - City:SALTVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24370-3577
Mailing Address - Country:US
Mailing Address - Phone:808-342-7843
Mailing Address - Fax:866-323-1118
Practice Address - Street 1:105 FALLING ROCK RD
Practice Address - Street 2:
Practice Address - City:SALTVILLE
Practice Address - State:VA
Practice Address - Zip Code:24370-3577
Practice Address - Country:US
Practice Address - Phone:808-265-5533
Practice Address - Fax:866-323-1118
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-26
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI53406163W00000X
HIAPRN-1861363LF0000X
VA0024172380363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse