Provider Demographics
NPI:1174022354
Name:SOLOMON, VANESSA (ARNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:ARNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 BLAIRS FERRY RD STE 104
Mailing Address - Street 2:
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233-2076
Mailing Address - Country:US
Mailing Address - Phone:319-393-0178
Mailing Address - Fax:
Practice Address - Street 1:1940 BLAIRS FERRY RD STE 104
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-2076
Practice Address - Country:US
Practice Address - Phone:319-393-0178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-02
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9248682363LP0200X
FLARNP9248682363LF0000X
IAA129973363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAA129973OtherIA DOH
FLAPRN9248682OtherFL DOH