Provider Demographics
NPI:1356320113
Name:SNIDER, DUANE (DC MSN FNP-C)
Entity type:Individual
Prefix:DR
First Name:DUANE
Middle Name:
Last Name:SNIDER
Suffix:
Gender:
Credentials:DC MSN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 E WABASH ST
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IN
Mailing Address - Zip Code:46041-2750
Mailing Address - Country:US
Mailing Address - Phone:765-659-1881
Mailing Address - Fax:888-846-1033
Practice Address - Street 1:5515 W 38TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-2995
Practice Address - Country:US
Practice Address - Phone:317-880-3838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28270166C163W00000X
IN71015126A363LF0000X
IN08001674A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000174402OtherBLUE CROSS BLUE SHIELD #
IN200122790AMedicaid
IN000000174402OtherBLUE CROSS BLUE SHIELD #
INUC5516Medicare UPIN