Healthcare Provider Details

I. General information

NPI: 1295059293
Provider Name (Legal Business Name): STEPHANIE RENEE SOLIS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 E TOWN ST STE 116
COLUMBUS OH
43215-4799
US

IV. Provider business mailing address

PO BOX 7527
DUBLIN OH
43017-0727
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-9108
  • Fax: 614-566-8737
Mailing address:
  • Phone: 614-566-9108
  • Fax: 614-566-8737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.024040
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: