Provider Demographics
NPI:1407631732
Name:SOLTIS, LISA M (MSN, APRN, CCNS)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:SOLTIS
Suffix:
Gender:F
Credentials:MSN, APRN, CCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 RYMARK CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-2634
Mailing Address - Country:US
Mailing Address - Phone:919-621-3921
Mailing Address - Fax:
Practice Address - Street 1:811 RYMARK CT
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-2634
Practice Address - Country:US
Practice Address - Phone:919-621-3921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC149420364SC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine