Provider Demographics
NPI:1336631548
Name:HARPER, KRISTIN E (DPM)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:E
Last Name:HARPER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 COLLEGE AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2231
Mailing Address - Country:US
Mailing Address - Phone:724-774-1525
Mailing Address - Fax:247-774-0366
Practice Address - Street 1:336 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-2231
Practice Address - Country:US
Practice Address - Phone:724-774-1525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PASC007229213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program