Provider Demographics
NPI:1265840565
Name:SOLOMON, VANESSA MARION
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:MARION
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1059 ERICKSON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-1240
Mailing Address - Country:US
Mailing Address - Phone:614-754-0155
Mailing Address - Fax:
Practice Address - Street 1:1059 ERICKSON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-1240
Practice Address - Country:US
Practice Address - Phone:614-754-0155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-30
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide