HIPAASpace NPI Form
WWW.HIPAASPACE.COM Source NPI Lookup
NATIONAL PROVIDER IDENTIFIER (NPI) FORM
Information provided in the current document is obtained from official source and accuracy of the information provided is the sole
responsibility of the healthcare provide. All changes, corrections or updates must be done through the official sources. Please contact
HIPAASpace.com in case you need the assistance in obtaining the official contacts of corresponding government organizations.
SECTION 1 – BASIC INFORMATION
NPI Number Provider (Organization) Full Name Provider (Organization) Other Name Entity Type Replacement NPI
1013050988 SNYDER HOLLY LYNN GENETIC COUNSELOR Individual
Gender Enumeration Date Last Update Date Deactivation Reason Code Deactivation Date Reactivation Date Employer Identification Number (EIN)
Female 02/14/2007 10/22/2010
SECTION 2 – CONTACT INFORMATION
Business Mailing Address
500 J. CLYDE MORRIS BOULEVARD BUILDING G, SUITE 200, NEWPORT NEWS VA23601 US
Practice Location Address
500 J CLYDE MORRIS BLVD , NEWPORT NEWS VA236011929-236011929 US
Business Phone Number Business Fax Number Practice Phone Number Practice Fax Number
7575345791 7575944310 7574943636 7576242272
Authorized Official – Name Authorized Official – Title/Position Authorized Official - Phone Number
SECTION 3 – LICENCING, IDENTIFICATION INFORMATION
A. TAXONOMY INFORMATION
1. Code: 170300000X (Genetic Counselor, MS). License Number : 2005129 VA.
B. OTHER PROVIDER IDENTIFIERS
www.hipaaspace.com NPI Profile: 1013050988 SNYDER HOLLY LYNN GENETIC COUNSELOR