Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 5012050 | NC |
N | 363LA2200X | Nurse Practitioner - Adult Health | 5012050 | NC |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 5012050 | NC |
N | 363LP2300X | Nurse Practitioner - Primary Care | 5012050 | NC |
NPI | 1083268254 |
---|---|
Provider Name | Tabetha Snow |
First Address | Asheville, NC 28801-4184 |
Second Address | Mc Leansville, NC 27301-9622 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2019 |
Last Update Date | 05/03/2020 |