# MOUNTAIN SAGE MEDICO

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326777418
- **Authorized official:** SUSAN BARRETT APRN-CNP (OWNER)
- **Authorized official phone:** (505) 472-7243

## Contact information

- **Practice address:** 1660 OLD PECOS TRL STE F, SANTA FE, NM 87505-4768
- **Practice address phone:** (505) 472-7243
- **Practice address fax:** (505) 472-7244
- **Mailing address:** 1660 OLD PECOS TRL STE F, SANTA FE, NM 87505-4768
- **Mailing address phone:** (505) 472-7243
- **Mailing address fax:** (505) 472-7244

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | — | — | — |
| 207RR0500X | Rheumatology Physician | — | NULL | Yes |
| 207RR0500X | Rheumatology Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 06/06/2022
- **Last updated:** 09/29/2023