Provider Demographics
NPI:1346547148
Name:HARKEN, KRISTY LYN (DPT)
Entity Type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:LYN
Last Name:HARKEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1785 NW 73RD PL
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-9372
Mailing Address - Country:US
Mailing Address - Phone:515-371-6065
Mailing Address - Fax:
Practice Address - Street 1:1450 SW VINTAGE PKWY
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-7165
Practice Address - Country:US
Practice Address - Phone:515-963-8723
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-15
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist