Provider Demographics
NPI:1063182921
Name:SNYDER, BRANDIE M (RN)
Entity type:Individual
Prefix:MS
First Name:BRANDIE
Middle Name:M
Last Name:SNYDER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 COTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IN
Mailing Address - Zip Code:47670-3323
Mailing Address - Country:US
Mailing Address - Phone:410-703-9117
Mailing Address - Fax:
Practice Address - Street 1:1619 COTTONWOOD DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IN
Practice Address - Zip Code:47670-3323
Practice Address - Country:US
Practice Address - Phone:410-703-9117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28217725A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse