Provider Demographics
NPI:1699972026
Name:HARDEN, KIMBERLY SUSANNE (MD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:SUSANNE
Last Name:HARDEN
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:PO BOX 820
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80901-0820
Mailing Address - Country:US
Mailing Address - Phone:719-448-0981
Mailing Address - Fax:
Practice Address - Street 1:2313 RED EDGE HTS
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-7207
Practice Address - Country:US
Practice Address - Phone:719-481-3588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018024912207L00000X
KY51386207L00000X
WI132-320207L00000X
ND15614207L00000X
MN63751207L00000X
NY295003207L00000X
KS04-41696207L00000X
NE30796207L00000X
IAMD-45201207L00000X
MEMD-22329207L00000X
TN59147207L00000X
SD10914207L00000X
IN01080517A207L00000X
MI4301114902207L00000X
CO49748207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology