Provider Demographics
NPI:1922629898
Name:SNATCHEDNSPIRIT LLC
Entity Type:Organization
Organization Name:SNATCHEDNSPIRIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DERMATOLOGY NP
Authorized Official - Prefix:
Authorized Official - First Name:CHARISSE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:251-423-4376
Mailing Address - Street 1:3993 COTTAGE HILL RD APT 19C3993
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-8418
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3993 COTTAGE HILL RD APT 19C3993
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-8418
Practice Address - Country:US
Practice Address - Phone:251-423-4376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-02
Last Update Date:2020-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty