Provider Demographics
NPI:1386603728
Name:SNIDER, LAURA FAYE (DNP, FNP-BC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:FAYE
Last Name:SNIDER
Suffix:
Gender:
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5189 W 600 N
Mailing Address - Street 2:
Mailing Address - City:MC CORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-9715
Mailing Address - Country:US
Mailing Address - Phone:317-335-5189
Mailing Address - Fax:317-335-3875
Practice Address - Street 1:5189 W 600 N
Practice Address - Street 2:
Practice Address - City:MC CORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46055-9715
Practice Address - Country:US
Practice Address - Phone:317-335-3774
Practice Address - Fax:317-335-3875
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-23
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000368A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200302730Medicaid
IN201010620OtherMEDICAID GROUP NUMBER
IN205110Medicare PIN
IN201010620OtherMEDICAID GROUP NUMBER
IN251480Medicare UPIN
INS55576Medicare UPIN