Provider Demographics
NPI:1477844223
Name:SNYDER, ONDREA (MS, APN)
Entity type:Individual
Prefix:
First Name:ONDREA
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MS, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 E VICTORIA CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60542-5107
Mailing Address - Country:US
Mailing Address - Phone:630-907-1778
Mailing Address - Fax:
Practice Address - Street 1:411 E VICTORIA CIR
Practice Address - Street 2:
Practice Address - City:NORTH AURORA
Practice Address - State:IL
Practice Address - Zip Code:60542-5107
Practice Address - Country:US
Practice Address - Phone:630-907-1778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.008663363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209.008663Medicaid