Provider Demographics
NPI:1366894867
Name:SNIDER, KATRINA LATRICE (PMHNP - BC)
Entity type:Individual
Prefix:MS
First Name:KATRINA
Middle Name:LATRICE
Last Name:SNIDER
Suffix:
Gender:F
Credentials:PMHNP - BC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:240 MITCHELL BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2043
Mailing Address - Country:US
Mailing Address - Phone:561-844-2379
Mailing Address - Fax:
Practice Address - Street 1:240 MITCHELL BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2043
Practice Address - Country:US
Practice Address - Phone:706-369-6363
Practice Address - Fax:706-389-6740
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN255430163W00000X, 363LP0808X
FLRN9341570163W00000X
NC258977163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse