Provider Demographics
NPI:1457924433
Name:HARKO, KRISTIN DAWN (NP)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:DAWN
Last Name:HARKO
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31001-4110
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91110-4110
Mailing Address - Country:US
Mailing Address - Phone:406-327-1950
Mailing Address - Fax:406-327-3080
Practice Address - Street 1:601 W SPRUCE ST STE K
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4047
Practice Address - Country:US
Practice Address - Phone:406-327-1950
Practice Address - Fax:406-327-3080
Is Sole Proprietor?:No
Enumeration Date:2021-07-19
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9111210-4405363L00000X, 363LA2100X, 363LG0600X
MTNUR-APRN-LIC-239188363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care