Individual provider · Type 1 NPI
Kenndal Soto, AGACNP-BC
Acute Care Nurse Practitioner · Detroit, MI
NPI number
1093317133
Active
Practice location
2799 W Grand Blvd
Detroit, MI 48202-2608
Fax (313) 876-1305
Mailing address
1 Ford Pl Ste 3A
Detroit, MI 48202-3450
Other practice locations
- 730 N Macomb St Ste 228, Monroe, MI 48162 · (734) 457-5580
- 8669 Maurice, Newport, MI 48166-9408 · (734) 770-4035
- 2940 N Mccord Rd, Toledo, OH 43615 · (419) 842-3000
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | APRN.CNP.0028440 (OH) |
| Nurse Practitioner | 363L00000X | 4704299368 (MI) |
| Acute Care Nurse Practitioner | 363LA2100X | APRN.CNP.0028440 (OH) |
| Acute Care Nurse Practitioner Primary | 363LA2100X | 4704299368 (MI) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1093317133
Kenndal Soto, AGACNP-BC's National Provider Identifier is 1093317133, issued on Nov 13, 2020. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Detroit, MI. The record was last updated on Dec 7, 2022.