Provider Demographics
NPI:1568247120
Name:HARDING, JASMINE DANIELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:DANIELLE
Last Name:HARDING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 HOULTON ST
Mailing Address - Street 2:
Mailing Address - City:PATTEN
Mailing Address - State:ME
Mailing Address - Zip Code:04765-3035
Mailing Address - Country:US
Mailing Address - Phone:330-858-4531
Mailing Address - Fax:
Practice Address - Street 1:30 HOULTON ST
Practice Address - Street 2:
Practice Address - City:PATTEN
Practice Address - State:ME
Practice Address - Zip Code:04765-3035
Practice Address - Country:US
Practice Address - Phone:866-366-5842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant