Provider Demographics
NPI:1841153020
Name:HARNDEN, KATHERINE PAIGE
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:PAIGE
Last Name:HARNDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:787 OAK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-4635
Mailing Address - Country:US
Mailing Address - Phone:321-313-9636
Mailing Address - Fax:
Practice Address - Street 1:787 OAK RIDGE DR
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903-4635
Practice Address - Country:US
Practice Address - Phone:321-313-9636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-04
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program