Provider Demographics
NPI:1487786588
Name:SNYDER, MARY DEBORAH (WHNP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:DEBORAH
Last Name:SNYDER
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:399 BUCK SWAMP RD
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27530-8030
Mailing Address - Country:US
Mailing Address - Phone:919-734-9269
Mailing Address - Fax:
Practice Address - Street 1:301 N HERMAN ST STE CC
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27530-2971
Practice Address - Country:US
Practice Address - Phone:919-731-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC114070363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCZF0000123Medicaid