Healthcare Provider Details

I. General information

NPI: 1891917647
Provider Name (Legal Business Name): JULIA SWART BSM LM CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 05/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11005 SPAIN RD NE STE 9
ALBUQUERQUE NM
87111-1871
US

IV. Provider business mailing address

12231 ACADEMY RD. NE #301
ALBUQUERQUE NM
87111
US

V. Phone/Fax

Practice location:
  • Phone: 505-227-1343
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: