Basic Information
Provider Information
NPI: 1881136695
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SNAPP
FirstName: TAYLOR
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: NURSE PRACTITIONER
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7800 NW 85TH TERRACE
Address2: SUITE 200
City: OKLAHOMA CITY
State: OK
PostalCode: 731323385
CountryCode: US
TelephoneNumber: 4059727239
FaxNumber:  
Practice Location
Address1: 5224 E I 240 SERVICE RD
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731352607
CountryCode: US
TelephoneNumber: 4056083800
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/10/2016
LastUpdateDate: 02/07/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X99462OKY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home