Provider Demographics
NPI:1851417125
Name:SNOW, JEANNE M (NP)
Entity Type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:M
Last Name:SNOW
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7208 WINEDALE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4836
Mailing Address - Country:US
Mailing Address - Phone:214-348-7123
Mailing Address - Fax:
Practice Address - Street 1:502 W KEARNEY ST
Practice Address - Street 2:STE 700
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-3401
Practice Address - Country:US
Practice Address - Phone:972-288-7337
Practice Address - Fax:972-289-9076
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX522589363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics