Provider Demographics
NPI:1902339716
Name:SOLOMON, TSION
Entity Type:Individual
Prefix:
First Name:TSION
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TSION
Other - Middle Name:ABEBE
Other - Last Name:HAILE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10918 DAKOTA CT
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-1114
Mailing Address - Country:US
Mailing Address - Phone:612-636-5412
Mailing Address - Fax:
Practice Address - Street 1:10918 DAKOTA CT
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-1114
Practice Address - Country:US
Practice Address - Phone:612-636-5412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-233696-3163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse