Provider Demographics
NPI:1396954400
Name:SNOOK, BETH ELAINE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ELAINE
Last Name:SNOOK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MISS
Other - First Name:BETH
Other - Middle Name:ELAINE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6521 DONAHUE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-7641
Mailing Address - Country:US
Mailing Address - Phone:563-940-2344
Mailing Address - Fax:
Practice Address - Street 1:4190 E WOODMEN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-8075
Practice Address - Country:US
Practice Address - Phone:719-632-4455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.358885163W00000X
CO1618400163WM0705X
CO0991655363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical