Individual
KENLLY J SOTO BALBUENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2478 SIMONELLI DR, VINELAND, NJ 08361-7748
(609) 579-3477
Mailing address
2478 SIMONELLI DR, VINELAND, NJ 08361-7748
(609) 579-3477
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ15083500
NJ
Other
Enumeration date
07/18/2024
Last updated
07/18/2024
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