Provider Demographics
NPI:1861833303
Name:SOLOMON, DAPHNE ANNE (FNP-C)
Entity Type:Individual
Prefix:DR
First Name:DAPHNE
Middle Name:ANNE
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:DR
Other - First Name:DAPHNE
Other - Middle Name:ANNE
Other - Last Name:SOLOMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP
Mailing Address - Street 1:PO BOX 30180
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84130-0180
Mailing Address - Country:US
Mailing Address - Phone:435-590-6639
Mailing Address - Fax:
Practice Address - Street 1:110 W 1325 N
Practice Address - Street 2:SUITE 300
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-8101
Practice Address - Country:US
Practice Address - Phone:435-865-9500
Practice Address - Fax:435-586-8995
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2016-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5129289-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily