Provider Demographics
NPI:1255513164
Name:SNEED, THERESA ROCHELLE (RN)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:ROCHELLE
Last Name:SNEED
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 MIRIMAR ST APT 2
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45409-1414
Mailing Address - Country:US
Mailing Address - Phone:937-389-6825
Mailing Address - Fax:
Practice Address - Street 1:50 S FINDLAY ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45403-2023
Practice Address - Country:US
Practice Address - Phone:937-252-1661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.336737163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse