MEDICARE: CHEYANNE TAYLOR SOLORIO PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	14249226-1206	UT

General Provider Information

NPI Number	:	1568102994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHEYANNE TAYLOR SOLORIO PA-C

Provider Business Mailing Address
First Line	:	PO BOX 5210
Second Line	:
City	:	GRAND FORKS
State	:	ND
Zip	:	58206-5210
Country	:	US
Telephone Number	:	701-205-3000
Fax Number	:	701-732-2501

Provider Business Practice Location Address
First Line	:	3674 S WASHINGTON ST
Second Line	:
City	:	GRAND FORKS
State	:	ND
Zip	:	58201-5766
Country	:	US
Telephone Number	:	701-205-3000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2022
Last Update Date	:	12/22/2025

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