Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | MD2007-0256 | NM |
NPI | 1003875089 |
---|---|
Provider Name | Kelly Drescher |
First Address | Albuquerque, NM 87106-4920 |
Second Address | Albuquerque, NM 87106-4920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 22/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
27929221 | (05) | NM |
H95940 | (02) |