Provider Demographics
NPI:1023634201
Name:SNYDER, MOLLY ELEISE
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:ELEISE
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 1:6701 BAUM DR
Mailing Address - Street 2:STE 140
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-7361
Mailing Address - Country:US
Mailing Address - Phone:205-871-9661
Mailing Address - Fax:205-870-1621
Practice Address - Street 1:801 N WEISGARBER RD STE 200
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2707
Practice Address - Country:US
Practice Address - Phone:865-983-0847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-168862363LF0000X
LA227519363LF0000X
GAGAA-NP001521363LF0000X
TNAPN0000029435363LF0000X
TN29435363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-168862OtherSTATE LICENSE