Provider Demographics
NPI:1194113290
Name:SNYDER, JENNIFER ANNE (RD)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANNE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 1ST STREET NW
Mailing Address - Street 2:
Mailing Address - City:BRITT
Mailing Address - State:IA
Mailing Address - Zip Code:50423
Mailing Address - Country:US
Mailing Address - Phone:641-843-5014
Mailing Address - Fax:641-843-5501
Practice Address - Street 1:532 1ST STREET NW
Practice Address - Street 2:
Practice Address - City:BRITT
Practice Address - State:IA
Practice Address - Zip Code:50423
Practice Address - Country:US
Practice Address - Phone:641-843-5014
Practice Address - Fax:641-843-5501
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-26
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01222133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered