Provider Demographics
NPI:1265419733
Name:SOLOMON, SHEELA M
Entity type:Individual
Prefix:
First Name:SHEELA
Middle Name:M
Last Name:SOLOMON
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 1:6465 WAYZATA BLVD
Mailing Address - Street 2:STE 315
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1728
Mailing Address - Country:US
Mailing Address - Phone:952-993-7169
Mailing Address - Fax:952-993-0300
Practice Address - Street 1:2001 BLAISDELL AVE
Practice Address - Street 2:PARK NICOLLET CLINIC - MINNEAPOLIS
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2414
Practice Address - Country:US
Practice Address - Phone:952-993-8000
Practice Address - Fax:952-993-8039
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNR 124246-9163WW0101X
MNCNP 2830363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory