Provider Demographics
NPI:1952449084
Name:SNYDER-MORRIS, PENNY PAGE (MSN,FNP)
Entity Type:Individual
Prefix:
First Name:PENNY
Middle Name:PAGE
Last Name:SNYDER-MORRIS
Suffix:
Gender:F
Credentials:MSN,FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7924 KINGS HIGHWAY
Mailing Address - Street 2:PO BOX 837
Mailing Address - City:MONTROSS
Mailing Address - State:VA
Mailing Address - Zip Code:22520
Mailing Address - Country:US
Mailing Address - Phone:804-224-0740
Mailing Address - Fax:
Practice Address - Street 1:18849 KINGS HIGHWAY
Practice Address - Street 2:
Practice Address - City:MONTROSS
Practice Address - State:VA
Practice Address - Zip Code:22520
Practice Address - Country:US
Practice Address - Phone:804-493-1124
Practice Address - Fax:804-493-9352
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024062777363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAS75133Medicare UPIN