Provider Demographics
NPI:1912652694
Name:SNELSON, ROSE-ELYSE CALVO DAMRON (PA)
Entity Type:Individual
Prefix:
First Name:ROSE-ELYSE
Middle Name:CALVO DAMRON
Last Name:SNELSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:SNELSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2120 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37210-3968
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:353 NEW SHACKLE ISLAND RD STE 128B
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2329
Practice Address - Country:US
Practice Address - Phone:615-822-8908
Practice Address - Fax:615-822-8909
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty