Provider Demographics
NPI:1992533657
Name:SNYDER, MACKENZIE LORIANN (RPH)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:LORIANN
Last Name:SNYDER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-7558
Mailing Address - Country:US
Mailing Address - Phone:701-223-0936
Mailing Address - Fax:701-224-0007
Practice Address - Street 1:707 S 3RD ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-7558
Practice Address - Country:US
Practice Address - Phone:701-223-0936
Practice Address - Fax:701-224-0007
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH6589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist