Provider Demographics
NPI:1497267975
Name:ORTIZ, JULIE MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MARIE
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:ACOSTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2308 CERRILLOS RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-3264
Mailing Address - Country:US
Mailing Address - Phone:505-471-7874
Mailing Address - Fax:
Practice Address - Street 1:2308 CERRILLOS RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3264
Practice Address - Country:US
Practice Address - Phone:505-471-7874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-24
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS022929183500000X
NMRP00008844183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist