Provider Demographics
NPI:1265957054
Name:SNOW, LAURA ALLESE (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ALLESE
Last Name:SNOW
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:ALLESE
Other - Last Name:SNOW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:166 JC JONES RD
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37166-5431
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 SAM WALTON DR STE 600
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-8814
Practice Address - Country:US
Practice Address - Phone:931-739-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23010363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily