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General NPI Number Information
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NPI Number | 1124434253
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Entity Type | Individual
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Provider Name | TARA ROCHELLE KOLBERG WHNP
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Gender | Female
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 6801 JEFFERSON ST NE STE 350
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4361
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Country | US
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Telephone | 505-847-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 1718 MENAUL BLVD NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-1030
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Country | US
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Telephone | 505-249-7592
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | DEM-LD-10163507
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 63727
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License Number State | NM
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