Provider Demographics
NPI:1740693670
Name:DRUMMOND, CHANNING C (ACNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CHANNING
Middle Name:C
Last Name:DRUMMOND
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:CHANNING
Other - Middle Name:
Other - Last Name:CLAWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 10597
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78766-1597
Mailing Address - Country:US
Mailing Address - Phone:512-485-5889
Mailing Address - Fax:512-420-0397
Practice Address - Street 1:7200 WYOMING SPRINGS DR STE 1300
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4306
Practice Address - Country:US
Practice Address - Phone:512-244-2273
Practice Address - Fax:512-924-4131
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1054101363L00000X
TN18753363LA2100X
NMCNP-02854363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care