Provider Demographics
NPI:1376213439
Name:HARDING, KRISTEN JANE (NP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:JANE
Last Name:HARDING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 CINNAMON CIR
Mailing Address - Street 2:
Mailing Address - City:SOUTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-1772
Mailing Address - Country:US
Mailing Address - Phone:781-264-3369
Mailing Address - Fax:
Practice Address - Street 1:650 CENTRE ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-3308
Practice Address - Country:US
Practice Address - Phone:508-941-7379
Practice Address - Fax:508-941-6330
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN260802363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner