Nicole Anne Soto
Individual provider Active NPI Pediatric Nurse Practitioner · Eielson Afb, AK
NPI 1073852265 · NPPES record last updated Jun 25, 2024
Key facts
- NPI
- 1073852265
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- AP123904 (TX)
- Practice address
- 2630 Central Ave
Eielson Afb, AK 99702-2301 - NPI assigned
- Feb 7, 2013
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP123904 | TX | MD | Pediatric Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | AP123904 | TX | Yes |
Addresses
Primary practice location
2630 Central Ave
Eielson Afb, AK 99702-2301
Mailing address
2630 Central Ave
Eielson Afb, AK 99702-2301
Phone (907) 377-4727
Other practice location 1
2630 Central Ave
Eielson AFB, AK 99702-2301
Other providers in Eielson Afb, AK
- Brandon Richards
- Zach L Rodgers
- Stephanie Danielle Rowe
- Susan Mary Runyan
- Stacey R. Schmitt
- Parker Leroy Spriggs
- Collin M Stevens
- Miles A. Stutes
- Caitlin Renee Treloar
- Drayden Turman
All providers in Eielson Afb, AK · Pediatric Nurse Practitioner in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.