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General NPI Number Information
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NPI Number | 1306298138
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Entity Type | Individual
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Provider Name | SOLOMON KORSSA
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Gender | Male
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Dates
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Enumeration Date | 07/05/2016
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 4750 E GALBRAITH RD STE 210
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City | CINCINNATI
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State | OH
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Zip | 45236-6705
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Country | US
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Telephone | 513-686-4830
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Fax | 513-686-4836
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Provider Business Mailing Address
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Address Line | 4750 E GALBRAITH RD STE 210
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City | CINCINNATI
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State | OH
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Zip | 45236-6705
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Country | US
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Telephone | 513-686-4830
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Fax | 513-686-4836
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0028536
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0028536
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN389422
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License Number State | OH
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