Provider Demographics
NPI:1831985472
Name:TATHAM, KEZIA ELIZABETH (CNM)
Entity type:Individual
Prefix:MRS
First Name:KEZIA
Middle Name:ELIZABETH
Last Name:TATHAM
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Gender:F
Credentials:CNM
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Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:PHS PROVIDER ENROLLMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:917-530-3041
Mailing Address - Fax:
Practice Address - Street 1:3630 LAS ESTANCIAS DR SW
Practice Address - Street 2:OBSTETRICS AND GYNECOLOGY
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-5504
Practice Address - Country:US
Practice Address - Phone:505-462-7777
Practice Address - Fax:505-462-7726
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-08-12
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Provider Licenses
StateLicense IDTaxonomies
NM915367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife