Provider Demographics
NPI:1083457352
Name:KHALSA PSYCHIATRIC SERVICES - A NURSING CORPORATION
Entity type:Organization
Organization Name:KHALSA PSYCHIATRIC SERVICES - A NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUKH DEV SINGH
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALSA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP-BC, RN
Authorized Official - Phone:323-301-9652
Mailing Address - Street 1:608 WOODDUCK LN
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-9251
Mailing Address - Country:US
Mailing Address - Phone:323-301-9652
Mailing Address - Fax:
Practice Address - Street 1:103 N HAMILTON ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-9571
Practice Address - Country:US
Practice Address - Phone:323-301-9652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-14
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty