Healthcare Provider Details
I. General information
NPI: 1245384254
Provider Name (Legal Business Name): SHARON JEAN SOLOMON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/23/2007
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2801 W KINNICKINNIC RIVER PKWY SUITE 630
MILWAUKEE WI
53215-3669
US
IV. Provider business mailing address
PO BOX 735044
CHICAGO IL
60673-5044
US
V. Phone/Fax
- Phone: 414-385-1922
- Fax: 414-385-1899
- Phone: 800-326-2250
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 2690-33 |
| License Number State | WI |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 2690 |
| License Number State | WI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: