Healthcare Provider Details

I. General information

NPI: 1164317582
Provider Name (Legal Business Name): MARIAM SOLIMAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 POPLAR AVE STE 250
MEMPHIS TN
38119-3974
US

IV. Provider business mailing address

1673 BRIDGECREST DR
ANTIOCH TN
37013-1927
US

V. Phone/Fax

Practice location:
  • Phone: 574-546-1900
  • Fax: 574-546-1999
Mailing address:
  • Phone: 615-424-2765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number39097
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: