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1154918381
KELLI SUZANNE WATKINS
RIO RANCHO, NM
NPI
1154918381
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Former Name
KELLI LIGHT
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NM PA2020-0113)
Enumeration Date
2020-12-22
Last Update Date
2021-10-27
Business Address
Mrs. KELLI SUZANNE WATKINS PA-C
2400 UNSER BLVD SE STE 19400
RIO RANCHO, NM 87124-4740
Phone number: 505-253-6100
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Mailing Address
Mrs. KELLI SUZANNE WATKINS PA-C
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQEURQUE, NM 87125-6666
Phone number: 505-923-6770
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