Provider Demographics
NPI:1740368158
Name:SNOOK, JOE L (CRNA)
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:L
Last Name:SNOOK
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:330 ARKANSAS ST STE 210
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1394
Mailing Address - Country:US
Mailing Address - Phone:785-842-7026
Mailing Address - Fax:785-842-7088
Practice Address - Street 1:330 ARKANSAS ST STE 210
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1394
Practice Address - Country:US
Practice Address - Phone:785-842-7026
Practice Address - Fax:785-842-7088
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS54397367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100383510CMedicaid
KS100383510CMedicaid