Provider Demographics
NPI:1336593292
Name:SNEED, LARRY DEWAYNE (APRN)
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:DEWAYNE
Last Name:SNEED
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 AVALON AVE STE 320
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-2880
Mailing Address - Country:US
Mailing Address - Phone:615-896-7440
Mailing Address - Fax:
Practice Address - Street 1:764 BECKRIDGE RD
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-7479
Practice Address - Country:US
Practice Address - Phone:931-304-6003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-18
Last Update Date:2018-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011769363LP0808X
TN82405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health