Healthcare Provider Details

I. General information

NPI: 1306349428
Provider Name (Legal Business Name): MISTY CHOATE SOTO FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2018
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 TERRY PKWY STE O
GRETNA LA
70056-4300
US

IV. Provider business mailing address

PO BOX 740012
ATLANTA GA
30374-0012
US

V. Phone/Fax

Practice location:
  • Phone: 504-534-1229
  • Fax: 504-553-1176
Mailing address:
  • Phone: 504-534-1229
  • Fax: 504-553-1176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP09756
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: