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Organization
MOUNTAIN SAGE MEDICO
Active
Organization
MOUNTAIN SAGE MEDICO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN BARRETT APRN-CNP (OWNER)
(505) 472-7243
Entity
Organization
Contact information
Practice address
1660 OLD PECOS TRL STE F, SANTA FE, NM 87505-4768
(505) 472-7243
(505) 472-7244
Mailing address
1660 OLD PECOS TRL STE F, SANTA FE, NM 87505-4768
(505) 472-7243
(505) 472-7244
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
NULL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RR0500X
Rheumatology Physician
Primary
—
NULL
207RR0500X
Rheumatology Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/06/2022
Last updated
09/29/2023
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