Provider Demographics
NPI:1780881839
Name:LOVELY-SNYDER, EUNIECIA TRACY (LPN)
Entity type:Individual
Prefix:MRS
First Name:EUNIECIA
Middle Name:TRACY
Last Name:LOVELY-SNYDER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 CENTRE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-3392
Mailing Address - Country:US
Mailing Address - Phone:231-929-2959
Mailing Address - Fax:
Practice Address - Street 1:828 CENTRE ST APT 4
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-3392
Practice Address - Country:US
Practice Address - Phone:231-929-2959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703091747164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse