Provider Demographics
NPI:1679862353
Name:BURMAN-SOLGAN, JACKIE ANN (FNP)
Entity Type:Individual
Prefix:
First Name:JACKIE
Middle Name:ANN
Last Name:BURMAN-SOLGAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10469 MONTEREY CT
Mailing Address - Street 2:
Mailing Address - City:MENTONE
Mailing Address - State:CA
Mailing Address - Zip Code:92359-1535
Mailing Address - Country:US
Mailing Address - Phone:909-794-2062
Mailing Address - Fax:
Practice Address - Street 1:10469 MONTEREY CT
Practice Address - Street 2:
Practice Address - City:MENTONE
Practice Address - State:CA
Practice Address - Zip Code:92359-1535
Practice Address - Country:US
Practice Address - Phone:909-794-2062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347894363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily