Provider Demographics
NPI:1881036135
Name:SOLTIS, KELLY CRONOMIZ (MSN, NP, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:CRONOMIZ
Last Name:SOLTIS
Suffix:
Gender:F
Credentials:MSN, NP, PMHNP-BC
Other - Prefix:MRS
Other - First Name:KELLY
Other - Middle Name:MARIE
Other - Last Name:CRONOMIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, LNP, PMHNP-BC
Mailing Address - Street 1:452 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-2815
Mailing Address - Country:US
Mailing Address - Phone:937-376-8700
Mailing Address - Fax:937-376-8725
Practice Address - Street 1:452 W MARKET ST
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-2815
Practice Address - Country:US
Practice Address - Phone:937-376-8700
Practice Address - Fax:937-376-8725
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171041363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health