MEDICARE: REBECCA ANNE SOLOMON NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209020176	IL
2	363LF0000X	Family Nurse Practitioner	A156445	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770133159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA ANNE SOLOMON NP-C

Provider Business Mailing Address
First Line	:	1230 E RUSHOLME ST
Second Line	:
City	:	DAVENPORT
State	:	IA
Zip	:	52803-2452
Country	:	US
Telephone Number	:	563-421-8980
Fax Number	:	563-421-8989

Provider Business Practice Location Address
First Line	:	1230 E RUSHOLME ST
Second Line	:
City	:	DAVENPORT
State	:	IA
Zip	:	52803-2452
Country	:	US
Telephone Number	:	563-421-8980
Fax Number	:	563-421-8989

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2019
Last Update Date	:	09/16/2024

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Directions to “ REBECCA ANNE SOLOMON NP-C” Practice Location

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