Healthcare Provider Details

I. General information

NPI: 1164990123
Provider Name (Legal Business Name): KARA NATKO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2018
Last Update Date: 12/07/2021
Certification Date: 12/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7103 4TH ST NW
LOS RANCHOS NM
87107-6641
US

IV. Provider business mailing address

9500 OSUNA RD NE APT 533
ALBUQUERQUE NM
87111-2287
US

V. Phone/Fax

Practice location:
  • Phone: 505-358-7155
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03438287
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: