Solola, Marie Chrystal

Solola, Marie Chrystal is an individual health care provider with primary practice located at 10400 75Th St , Kenosha WI 53142. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Solola, Marie Chrystal can be contacted via phone (262) 948-5600.

Contact Information

Primary practice address
10400 75Th St Kenosha WI 53142
Phone: (262) 948-5600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 85000396 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 4577 Wisconsin

Profile Details

NPI number 1467658195
LBN Legal business name Solola, Marie Chrystal
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2007
Last updated May 5th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467658195 NPPES
Wisconsin MEDICAID 100084078

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