Individual
AUDRA DAWN CLEMENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4930
(505) 724-6124
(505) 724-6125
Mailing address
PO BOX 26666, ALBUQUERQUE, NM 87125-6666
(505) 724-6124
(505) 724-6125
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2008-0015
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
27483754
—
NM
Enumeration date
08/13/2008
Last updated
04/30/2025
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