Provider Demographics
NPI:1598329344
Name:DONNELL, ALLISON DREW (DOM, ND)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:DREW
Last Name:DONNELL
Suffix:
Gender:F
Credentials:DOM, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 PLAZA BLANCA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-6517
Mailing Address - Country:US
Mailing Address - Phone:405-615-0332
Mailing Address - Fax:
Practice Address - Street 1:2929 PLAZA BLANCA
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-6517
Practice Address - Country:US
Practice Address - Phone:405-615-0332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-26
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1284171100000X
NM0007175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM007OtherNEW MEXICO MEDICAL BOARD, ND LICENSE NUMBER
NM1284OtherNEW MEXICO REG AND LICENSING, DOM LICENSE NUMBER