Individual
KATHRYN TANIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
883 LEAD AVE SE, STE A, ALBUQUERQUE, NM 87102-3644
(505) 247-8820
(505) 246-9421
Mailing address
9512 ALLANDE RD NE, ALBUQUERQUE, NM 87109-6618
(505) 299-2148
(505) 299-2148
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
CNP00550
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51452715
—
NM
Enumeration date
05/17/2006
Last updated
09/23/2014
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