Provider Demographics
NPI:1174886931
Name:MISSIBI, SOLANGE N (APRN, PMHNP)
Entity type:Individual
Prefix:MS
First Name:SOLANGE
Middle Name:N
Last Name:MISSIBI
Suffix:
Gender:F
Credentials:APRN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2508 DIDCOT CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2978
Mailing Address - Country:US
Mailing Address - Phone:301-272-5100
Mailing Address - Fax:202-920-1223
Practice Address - Street 1:2508 DIDCOT CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2978
Practice Address - Country:US
Practice Address - Phone:301-272-5100
Practice Address - Fax:202-920-1223
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1025932163W00000X
374U00000X
DCNP1025932363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No374U00000XNursing Service Related ProvidersHome Health Aide