Provider Demographics
NPI:1497048680
Name:SOLOMON, KATHY ANN (RN)
Entity Type:Individual
Prefix:MISS
First Name:KATHY
Middle Name:ANN
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30229 FORESTGROVE RD
Mailing Address - Street 2:
Mailing Address - City:WILLOWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44095-4956
Mailing Address - Country:US
Mailing Address - Phone:440-310-1827
Mailing Address - Fax:
Practice Address - Street 1:30229 FORESTGROVE RD
Practice Address - Street 2:
Practice Address - City:WILLOWICK
Practice Address - State:OH
Practice Address - Zip Code:44095-4956
Practice Address - Country:US
Practice Address - Phone:440-310-1827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-20
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.353934163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse