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General NPI Number Information
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NPI Number | 1669369492
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Entity Type | Individual
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Provider Name | KAYLA MARIE SODER APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 3498 TESUQUE DR
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City | ALAMOGORDO
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State | NM
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Zip | 88310-8613
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Country | US
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Telephone | 845-781-3571
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Fax |
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Provider Business Mailing Address
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Address Line | 3498 TESUQUE DR
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City | ALAMOGORDO
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State | NM
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Zip | 88310-8613
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Country | US
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Telephone | 845-781-3571
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9512525
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 84773
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License Number State | NM
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