Provider Demographics
NPI:1770542706
Name:HARPER, KATHLEEN (DO)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:HARPER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 GREAT FALLS PLZ
Mailing Address - Street 2:STE 3
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-5966
Mailing Address - Country:US
Mailing Address - Phone:207-782-4022
Mailing Address - Fax:207-784-3537
Practice Address - Street 1:2 GREAT FALLS PLZ
Practice Address - Street 2:STE 3
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-5966
Practice Address - Country:US
Practice Address - Phone:207-782-4022
Practice Address - Fax:207-784-3537
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDO2101207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTF84248Medicare UPIN
CT001002831Medicaid
CT060001491Medicare ID - Type Unspecified