Healthcare Provider Details

I. General information

NPI: 1689270597
Provider Name (Legal Business Name): ASHLEY ANNE SOLOMON AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS ASHLEY ANNE WEAVER

II. Dates (important events)

Enumeration Date: 12/07/2020
Last Update Date: 05/01/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CAMPUS DR UNIT 125
SCARBOROUGH ME
04074-7171
US

IV. Provider business mailing address

100 CAMPUS DR UNIT 125
SCARBOROUGH ME
04074-7171
US

V. Phone/Fax

Practice location:
  • Phone: 207-883-0069
  • Fax: 207-883-0999
Mailing address:
  • Phone: 207-883-0069
  • Fax: 207-883-0999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5018371
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPN.0995926-NP
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCNP251042
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberCNP251042
License Number StateME
# 5
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN89680
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: