Provider Demographics
NPI:1154372050
Name:SNIEZEK, PATRICIA ANN (GNP ANP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:SNIEZEK
Suffix:
Gender:F
Credentials:GNP ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:ST ANNES CHURCH
Mailing Address - City:NAYTAHWAUSH
Mailing Address - State:MN
Mailing Address - Zip Code:56566
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:40520 COUNTY HWY 34
Practice Address - Street 2:WHITE EARTH HEALTH CENTER
Practice Address - City:OGEMA
Practice Address - State:MN
Practice Address - Zip Code:56569
Practice Address - Country:US
Practice Address - Phone:218-983-4300
Practice Address - Fax:218-983-6217
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR0793333363L00000X, 363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN108214100Medicaid
0404850OtherMEDICA
177K6SNOtherBCBS
585241032125OtherPREFERRED ONE
MN108214100Medicaid
8HBD25Medicare ID - Type Unspecified
585241032125OtherPREFERRED ONE
8HBD24Medicare ID - Type Unspecified