Provider Demographics
NPI:1992802359
Name:SNOW, SUSAN G (FNP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:G
Last Name:SNOW
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:WEST BURKE
Mailing Address - State:VT
Mailing Address - Zip Code:05871-0163
Mailing Address - Country:US
Mailing Address - Phone:802-467-8343
Mailing Address - Fax:
Practice Address - Street 1:ORLEANS MEDICAL CLINIC
Practice Address - Street 2:30 EAST ST
Practice Address - City:ORLEANS
Practice Address - State:VT
Practice Address - Zip Code:05860
Practice Address - Country:US
Practice Address - Phone:802-754-2220
Practice Address - Fax:802-754-2195
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1010024308363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTONP1414Medicaid
VT00038944OtherBCBS
VTS65081Medicare UPIN
VT00038944OtherBCBS