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General NPI Number Information
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NPI Number | 1417286436
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Entity Type | Individual
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Provider Name | KELLEY ANN SOLOSKY CRNP
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Gender | Female
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Dates
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Enumeration Date | 12/22/2009
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 9889 GATE PKWY N STE 303
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City | JACKSONVILLE
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State | FL
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Zip | 32246-9230
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Country | US
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Telephone | 904-300-2809
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Fax | 888-496-8341
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Provider Business Mailing Address
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Address Line | 565 STATELY SHOALS TRL
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City | PONTE VEDRA
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State | FL
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Zip | 32081-5049
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Country | US
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Telephone | 302-893-5031
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN542909
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP010687
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11011318
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License Number State | FL
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