Healthcare Provider Details

I. General information

NPI: 1679400055
Provider Name (Legal Business Name): MICHELLE SOTO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/10/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4024 WATERSTONE DR
ELON NC
27244-7969
US

IV. Provider business mailing address

706 E DAVIS ST # 1004
BURLINGTON NC
27215-5924
US

V. Phone/Fax

Practice location:
  • Phone: 919-798-2206
  • Fax: 919-324-7381
Mailing address:
  • Phone: 919-695-7442
  • Fax: 919-324-7381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: