Provider Demographics
NPI:1982027785
Name:SNYDER, ALLISON
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25802 STATE ROAD 19
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:IN
Mailing Address - Zip Code:46030-9646
Mailing Address - Country:US
Mailing Address - Phone:317-984-3539
Mailing Address - Fax:
Practice Address - Street 1:25802 STATE ROAD 19
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:IN
Practice Address - Zip Code:46030-9646
Practice Address - Country:US
Practice Address - Phone:317-984-3539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004764A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health