Provider Demographics
NPI:1487771036
Name:SOLOMON, PATRICIA H (LPN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:H
Last Name:SOLOMON
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 1:1120 7 LKS N
Mailing Address - Street 2:PO BOX 9
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376-9756
Mailing Address - Country:US
Mailing Address - Phone:910-673-9111
Mailing Address - Fax:910-673-6202
Practice Address - Street 1:704 OLD LILESVILLE RD
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-2820
Practice Address - Country:US
Practice Address - Phone:704-694-6588
Practice Address - Fax:704-694-6706
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18077164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse