Provider Demographics
NPI:1407502560
Name:SNOW, COLETTE MICHELINE (CRNA)
Entity type:Individual
Prefix:DR
First Name:COLETTE
Middle Name:MICHELINE
Last Name:SNOW
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:COLETTE
Other - Middle Name:MICHELINE
Other - Last Name:MONTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6410 NORDIX DR
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20187-4440
Mailing Address - Country:US
Mailing Address - Phone:540-270-9920
Mailing Address - Fax:
Practice Address - Street 1:3600 JOSEPH SIEWICK DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1709
Practice Address - Country:US
Practice Address - Phone:703-391-3351
Practice Address - Fax:703-391-3006
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-28
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024183769363L00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner