Healthcare Provider Details

I. General information

NPI: 1487163929
Provider Name (Legal Business Name): CASEY L FIGUEREDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2017
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 COORS BLVD NW STE 200
ALBUQUERQUE NM
87120-1436
US

IV. Provider business mailing address

PO BOX 221530
EL PASO TX
79913-4530
US

V. Phone/Fax

Practice location:
  • Phone: 505-264-9961
  • Fax: 505-289-3887
Mailing address:
  • Phone: 915-598-7246
  • Fax: 915-633-6598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberF263-1129-7639
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2024-0128
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: