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General NPI Number Information
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NPI Number | 1912552555
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Entity Type | Individual
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Provider Name | AUDREY BLOTZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/08/2019
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 1100 CENTRAL AVE SE STE 5600 OBSTETRICS AND GYNECOLOGY HOSPITALIST
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-4930
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Country | US
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Telephone | 505-841-0922
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Fax | 505-563-6380
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Provider Business Mailing Address
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Address Line | PO BOX 26666 PRESBYTERIAN HEALTHCARE SERVICES
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City | ALBUQUERQUE
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State | NM
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Zip | 87125-6666
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Country | US
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Telephone | 505-923-5362
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2022-0107
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | WA
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