Provider Demographics
NPI:1457081838
Name:GUTRIDGE-SNODE, STEPHENIE ANN (MSN, CRNP)
Entity Type:Individual
Prefix:
First Name:STEPHENIE
Middle Name:ANN
Last Name:GUTRIDGE-SNODE
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41680 MISS BESSIE DR STE 301
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-2965
Mailing Address - Country:US
Mailing Address - Phone:240-526-7076
Mailing Address - Fax:
Practice Address - Street 1:41680 MISS BESSIE DR STE 301
Practice Address - Street 2:
Practice Address - City:LEONARDTOWN
Practice Address - State:MD
Practice Address - Zip Code:20650-2965
Practice Address - Country:US
Practice Address - Phone:240-526-7076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR216242163WC1500X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health