Healthcare Provider Details

I. General information

NPI: 1740201987
Provider Name (Legal Business Name): ANALISSA WATKINS DRUMMOND PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 MONTGOMERY BLVD NE STE 201
ALBUQUERQUE NM
87111-2467
US

IV. Provider business mailing address

9201 MONTGOMERY BLVD NE STE 201
ALBUQUERQUE NM
87111-2467
US

V. Phone/Fax

Practice location:
  • Phone: 505-298-2505
  • Fax: 505-298-2985
Mailing address:
  • Phone: 505-298-2505
  • Fax: 505-298-2985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2004-0054
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: