Individual
MRS. LAUREN JOHNSON SOLOMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
4126 WALNUT STREET, PHILADELPHIA, PA 19104-3511
(215) 387-0500
Mailing address
4126 WALNUT STREET, PHILADELPHIA, PA 19104-3511
(215) 387-0500
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
SP010139
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1007278000
PA MEDICAID TPI GROUP
PA
01
—
598576
MEDICARE TPI GROUP
PA
01
—
CD4829
TPI GROUP RAILROAD MEDICARE
PA
Enumeration date
02/04/2009
Last updated
09/15/2014
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