Healthcare Provider Details

I. General information

NPI: 1902801236
Provider Name (Legal Business Name): CARRIE BETH SOLODKY ND MSN ANP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 02/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 E BELL RD SUITE 3100
PHOENIX AZ
85032-3345
US

IV. Provider business mailing address

14780 W MOUNTAIN VIEW BLVD STE 110
SURPRISE AZ
85374-7280
US

V. Phone/Fax

Practice location:
  • Phone: 602-867-8644
  • Fax: 602-795-5698
Mailing address:
  • Phone: 623-322-6923
  • Fax: 855-420-6361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN104543
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: