Provider Demographics
NPI:1952314163
Name:HARPER, KIMBERLY S (DC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:S
Last Name:HARPER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11982 FISHERS CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2702
Mailing Address - Country:US
Mailing Address - Phone:317-580-1800
Mailing Address - Fax:317-580-9343
Practice Address - Street 1:11982 FISHERS CROSSING DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2702
Practice Address - Country:US
Practice Address - Phone:317-580-1800
Practice Address - Fax:317-436-7640
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001515A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
INU56708Medicare UPIN
265760AMedicare ID - Type Unspecified