Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | SP010747 | PA |
NPI | 1003134412 |
---|---|
Provider Name | Mrs. Lou-Ann Marie Snyder |
First Address | Allentown, PA 18102-3490 |
Second Address | Allentown, PA 18102-1852 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2010 |
Last Update Date | 25/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1025522200001 | (05) | PA |