Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 2016044695 | MO |
NPI | 1003339235 |
---|---|
Provider Name | Cora Ann Snyders |
First Address | Saint Louis, MO 63104-2466 |
Second Address | Brentwood, MO 63144-2602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2017 |
Last Update Date | 30/10/2020 |