Provider Demographics
NPI:1548321532
Name:SNAPP, REBECCA LYNN (CRNA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LYNN
Last Name:SNAPP
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:LYNN
Other - Last Name:SNAPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:3612 POTEET DR
Mailing Address - Street 2:APT 512
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-7642
Mailing Address - Country:US
Mailing Address - Phone:972-276-6100
Mailing Address - Fax:972-276-1231
Practice Address - Street 1:700 WALTER REED BLVD
Practice Address - Street 2:SUITE 305
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-3701
Practice Address - Country:US
Practice Address - Phone:972-276-6100
Practice Address - Fax:972-276-1231
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX234044367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159462401OtherTX MEDICAID GROUP NUMBER
TX470862522OtherTAX ID
TX160543802Medicaid
TXS38255Medicare UPIN
TX159462401OtherTX MEDICAID GROUP NUMBER