Healthcare Provider Details

I. General information

NPI: 1407794688
Provider Name (Legal Business Name): SAT KARTAR KARTAR KHALSA BSN, RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 MOORE ST APT B
SANTA FE NM
87501-2157
US

IV. Provider business mailing address

120 MOORE ST APT B
SANTA FE NM
87501-2157
US

V. Phone/Fax

Practice location:
  • Phone: 505-692-3338
  • Fax:
Mailing address:
  • Phone: 505-692-3338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number67172
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: