Provider Demographics
NPI:1912397142
Name:WESSEH, SOLOMON AFRICANUS JR (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SOLOMON
Middle Name:AFRICANUS
Last Name:WESSEH
Suffix:JR
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10135 43RD CT NE
Mailing Address - Street 2:
Mailing Address - City:SAINT MICHAEL
Mailing Address - State:MN
Mailing Address - Zip Code:55376-3015
Mailing Address - Country:US
Mailing Address - Phone:763-202-9461
Mailing Address - Fax:
Practice Address - Street 1:10135 43RD CT NE
Practice Address - Street 2:
Practice Address - City:SAINT MICHAEL
Practice Address - State:MN
Practice Address - Zip Code:55376-3015
Practice Address - Country:US
Practice Address - Phone:763-202-9461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP 3500363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care