Healthcare Provider Details

I. General information

NPI: 1083306153
Provider Name (Legal Business Name): DEYANERY SOLIS DNP, APN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2023
Last Update Date: 06/19/2023
Certification Date: 06/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 HADDON AVE
CAMDEN NJ
08103-3109
US

IV. Provider business mailing address

1601 HADDON AVE
CAMDEN NJ
08103-3109
US

V. Phone/Fax

Practice location:
  • Phone: 856-757-3700
  • Fax: 856-365-7972
Mailing address:
  • Phone: 856-757-3700
  • Fax: 856-365-7972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR14464000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ14862700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: