Provider Demographics
NPI:1699864272
Name:HARDING, KRISTEN LEIGH (MD)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LEIGH
Last Name:HARDING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7661 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-4237
Mailing Address - Country:US
Mailing Address - Phone:513-549-0494
Mailing Address - Fax:866-501-5412
Practice Address - Street 1:7661 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-4237
Practice Address - Country:US
Practice Address - Phone:513-549-0494
Practice Address - Fax:866-501-5412
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-089814207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H17476Medicare UPIN
WI026044100Medicare ID - Type Unspecified
WI34430500Medicaid