Provider Demographics
NPI:1275356891
Name:SOLIMAN, SALLY (AGACNP)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:SOLIMAN
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 WOFFORD RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3934
Mailing Address - Country:US
Mailing Address - Phone:504-319-8100
Mailing Address - Fax:
Practice Address - Street 1:105 RENEE LYNN CT
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-6511
Practice Address - Country:US
Practice Address - Phone:919-966-4359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5021123363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care