Healthcare Provider Details

I. General information

NPI: 1073071403
Provider Name (Legal Business Name): JO-ANN SOLIS MORALES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2019
Last Update Date: 03/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 HICKORY RD STE 240
PLYMOUTH MEETING PA
19462-2225
US

IV. Provider business mailing address

2025 HARBOUR GATES DR APT 294
ANNAPOLIS MD
21401-7507
US

V. Phone/Fax

Practice location:
  • Phone: 410-831-9457
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberR236597
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: