Basic Information
| Provider Information | |||||||||
| NPI: | 1275521395 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COLEMAN | ||||||||
| FirstName: | JULIA | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | C.N.M. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2702 N. 3RD ST. | ||||||||
| Address2: | STE. 4020 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850041130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6023233242 | ||||||||
| FaxNumber: | 6023233496 | ||||||||
| Practice Location | |||||||||
| Address1: | 1492 S. MILL AVE. | ||||||||
| Address2: | STE. 312 | ||||||||
| City: | TEMPE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 85281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809211100 | ||||||||
| FaxNumber: | 4809271092 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2005 | ||||||||
| LastUpdateDate: | 07/24/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 176B00000X | F0001501 | NY | N | Other Service Providers | Midwife | 176B00000X | RN110116 | AZ | Y | Other Service Providers | Midwife |
ID Information
| ID | Type | State | Issuer | Description | 802901 | 05 | AZ | MEDICAID |