Provider Demographics
NPI:1982124186
Name:HARRING, KRISTI DENA (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:DENA
Last Name:HARRING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:LYNN
Other - Last Name:DENA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 271600
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75027-1600
Mailing Address - Country:US
Mailing Address - Phone:972-544-6600
Mailing Address - Fax:972-544-6604
Practice Address - Street 1:1023 LIPSCOMB ST STE 200
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3102
Practice Address - Country:US
Practice Address - Phone:972-544-6600
Practice Address - Fax:972-544-6604
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA11356363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical