Healthcare Provider Details

I. General information

NPI: 1013871854
Provider Name (Legal Business Name): ARLENE WATSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3880 FOOTHILLS RD STE A
LAS CRUCES NM
88011-4631
US

IV. Provider business mailing address

3880 FOOTHILLS RD STE A
LAS CRUCES NM
88011-4631
US

V. Phone/Fax

Practice location:
  • Phone: 575-527-8799
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberG-1870
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: