Provider Demographics
NPI:1932246436
Name:ABRAHAM, SOLLY (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:SOLLY
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SOLLY
Other - Middle Name:
Other - Last Name:PAUL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11350 MCCORMICK RD
Mailing Address - Street 2:EXECUTIVE PLAZA 1, SUITE 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031-1002
Mailing Address - Country:US
Mailing Address - Phone:443-643-3000
Mailing Address - Fax:443-643-3001
Practice Address - Street 1:510 UPPER CHESAPEAKE DR
Practice Address - Street 2:SUITE 415
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4328
Practice Address - Country:US
Practice Address - Phone:443-643-3000
Practice Address - Fax:443-643-3001
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR127624363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health