Provider Demographics
NPI:1912424052
Name:SOLOMON, KENEYANA MESHELL (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KENEYANA
Middle Name:MESHELL
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:KENEYANA
Other - Middle Name:M
Other - Last Name:REDDICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2714 DAVENPORT DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31721-9285
Mailing Address - Country:US
Mailing Address - Phone:229-395-8774
Mailing Address - Fax:229-434-1658
Practice Address - Street 1:425 W 3RD AVE STE 105
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1969
Practice Address - Country:US
Practice Address - Phone:229-312-2373
Practice Address - Fax:229-312-2385
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN160371363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily