Provider Demographics
NPI:1508133521
Name:SOLOMON, JENNIFER LYN (LPN)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYN
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ROSLYN AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-1847
Mailing Address - Country:US
Mailing Address - Phone:330-835-4142
Mailing Address - Fax:
Practice Address - Street 1:800 ROSLYN AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-1847
Practice Address - Country:US
Practice Address - Phone:330-835-4142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-146823-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse