Provider Demographics
NPI:1982900106
Name:SNYDER, TINA LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:LYNN
Last Name:SNYDER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3141 HURON PEAK AVE
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-4628
Mailing Address - Country:US
Mailing Address - Phone:731-610-7379
Mailing Address - Fax:
Practice Address - Street 1:3141 HURON PEAK AVE
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-4628
Practice Address - Country:US
Practice Address - Phone:731-610-7379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-04
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0990703-NP363L00000X
CO990703207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine