Individual
KENNDAL SOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
(313) 876-1305
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
(313) 876-1305
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704299368
MI
363L00000X
Nurse Practitioner
APRN.CNP.0028440
OH
363LA2100X
Acute Care Nurse Practitioner
Primary
4704299368
MI
363LA2100X
Acute Care Nurse Practitioner
APRN.CNP.0028440
OH
Other
Enumeration date
11/13/2020
Last updated
12/07/2022
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