Provider Demographics
NPI:1114492329
Name:SOLMS, GRACE UNDERHILL (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:UNDERHILL
Last Name:SOLMS
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2719 SE I ST
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3996
Mailing Address - Country:US
Mailing Address - Phone:479-273-5437
Mailing Address - Fax:
Practice Address - Street 1:2719 SE I ST
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3996
Practice Address - Country:US
Practice Address - Phone:479-273-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN281628363LP0200X
VA0024181211363LP0200X
AR225954363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics