Basic Information
| Provider Information | |||||||||
| NPI: | 1861956583 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SNYDER | ||||||||
| FirstName: | MARISSA | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11960 LIONESS WAY | ||||||||
| Address2: | STE 230 | ||||||||
| City: | PARKER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801345644 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3033449090 | ||||||||
| FaxNumber: | 3033441922 | ||||||||
| Practice Location | |||||||||
| Address1: | 10101 RIDGEGATE PKWY | ||||||||
| Address2: | |||||||||
| City: | LONE TREE | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801245522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3302256125 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2019 | ||||||||
| LastUpdateDate: | 03/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | APN.0994414-NP | CO | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 363LA2200X | APN.0994414-NP | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.