Healthcare Provider Details

I. General information

NPI: 1770242265
Provider Name (Legal Business Name): ADEANE SOLLARS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2021
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 S BUSINESS HIGHWAY 13 STE A
LEXINGTON MO
64067-1572
US

IV. Provider business mailing address

819 S BUSINESS HIGHWAY 13
LEXINGTON MO
64067-1515
US

V. Phone/Fax

Practice location:
  • Phone: 877-344-3572
  • Fax: 866-288-4492
Mailing address:
  • Phone: 660-259-2440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2017043325
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2022001616
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: