=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619843554
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DROPSEED LIFESTYLE MEDICINE CENTER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/16/2025
-----------------------------------------------------
Last Update Date | 10/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 136 S MAIN ST
-----------------------------------------------------
City | LAS CRUCES
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88001-1266
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-636-7326
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 701
-----------------------------------------------------
City | LAS CRUCES
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88004-0701
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-636-7326
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST CLINICIAN, OWNER
-----------------------------------------------------
Name | DAVENA MARIE NORRIS
-----------------------------------------------------
Credential | PHARMD
-----------------------------------------------------
Telephone | 575-636-7326
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1835P0018X
-----------------------------------------------------
Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------