Healthcare Provider Details

I. General information

NPI: 1417984105
Provider Name (Legal Business Name): JULIE A AULDS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

349 E CORONADO RD
PHOENIX AZ
85004-1525
US

IV. Provider business mailing address

PO BOX 51558
LOS ANGELES CA
90051-5858
US

V. Phone/Fax

Practice location:
  • Phone: 844-793-1380
  • Fax:
Mailing address:
  • Phone: 844-793-1380
  • Fax: 770-559-1231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number255474
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209001322
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN10029619
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: