Provider Demographics
NPI:1083810345
Name:SOLOMON, SASHI P (ARNP)
Entity Type:Individual
Prefix:
First Name:SASHI
Middle Name:P
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4207 GLASS RD NE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-2549
Mailing Address - Country:US
Mailing Address - Phone:319-200-5900
Mailing Address - Fax:319-200-5919
Practice Address - Street 1:4207 GLASS RD NE
Practice Address - Street 2:SUITE 2
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-2549
Practice Address - Country:US
Practice Address - Phone:319-200-5900
Practice Address - Fax:319-200-5919
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAF102151363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1083810345Medicaid
IAI4701Medicare UPIN
IA1083810345Medicaid