Provider Demographics
NPI:1245088467
Name:SOLAK, VICTORIA (RN)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:SOLAK
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 1:175A MILLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:SHILOH
Mailing Address - State:NC
Mailing Address - Zip Code:27974-6221
Mailing Address - Country:US
Mailing Address - Phone:252-455-4088
Mailing Address - Fax:
Practice Address - Street 1:1664 WEEKSVILLE RD BLDG 128
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-6701
Practice Address - Country:US
Practice Address - Phone:252-335-6460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC298348163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse