Healthcare Provider Details

I. General information

NPI: 1497139265
Provider Name (Legal Business Name): JULIA BETH TOLER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2015
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 MONTGOMERY BLVD NE STE 301
ALBUQUERQUE NM
87109-1219
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-727-4500
  • Fax:
Mailing address:
  • Phone: 505-272-1476
  • Fax: 505-272-1109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN9468801
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number702
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number623
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: