Provider Demographics
NPI:1770242265
Name:SOLLARS, ADEANE
Entity Type:Individual
Prefix:
First Name:ADEANE
Middle Name:
Last Name:SOLLARS
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 1:819 S BUSINESS HIGHWAY 13
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:64067-1515
Mailing Address - Country:US
Mailing Address - Phone:660-259-2440
Mailing Address - Fax:
Practice Address - Street 1:811 S BUSINESS HIGHWAY 13 STE A
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MO
Practice Address - Zip Code:64067-1572
Practice Address - Country:US
Practice Address - Phone:877-344-3572
Practice Address - Fax:866-288-4492
Is Sole Proprietor?:No
Enumeration Date:2021-12-11
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017043325363LF0000X
MO2022001616363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily