Provider Demographics
NPI:1245384254
Name:SOLOMON, SHARON JEAN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:JEAN
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:JEAN
Other - Last Name:KULZICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2801 W KINNICKINNIC RIVER PKWY
Mailing Address - Street 2:SUITE 550
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-3669
Mailing Address - Country:US
Mailing Address - Phone:414-385-1922
Mailing Address - Fax:414-385-1899
Practice Address - Street 1:2801 W KINNICKINNIC RIVER PKWY
Practice Address - Street 2:SUITE 630
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-3669
Practice Address - Country:US
Practice Address - Phone:414-385-1922
Practice Address - Fax:414-385-1899
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2690363LF0000X
WI2690-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1245384254Medicaid
WIK400356369Medicare PIN