Provider Demographics
NPI:1366583692
Name:SNYDER, JODI (CNP)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:SNYDER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 MONROE ST NW STE 1A
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-4147
Mailing Address - Country:US
Mailing Address - Phone:330-602-5339
Mailing Address - Fax:330-602-4200
Practice Address - Street 1:1260 MONROE ST NW STE 1A
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-4147
Practice Address - Country:US
Practice Address - Phone:330-602-5339
Practice Address - Fax:330-602-4200
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-08636363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2005010276-22OtherBOARD CERTIFICATION NP
OHNP-08636OtherOHIO BOARD OF NURSING