Healthcare Provider Details

I. General information

NPI: 1568102994
Provider Name (Legal Business Name): CHEYANNE TAYLOR SOLORIO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2022
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 S MAIN ST STE 6
TOOELE UT
84074-2136
US

IV. Provider business mailing address

60 S MAIN ST STE 6
TOOELE UT
84074-2136
US

V. Phone/Fax

Practice location:
  • Phone: 435-255-6150
  • Fax:
Mailing address:
  • Phone: 435-255-6150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number14249226-1206
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: