Provider Demographics
NPI:1861262065
Name:HARDEN, KYLIE
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:
Last Name:HARDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 SPRINGMILL DR
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:KY
Mailing Address - Zip Code:41076-1947
Mailing Address - Country:US
Mailing Address - Phone:859-512-5882
Mailing Address - Fax:
Practice Address - Street 1:330 THOMAS MORE PKWY STE 201
Practice Address - Street 2:
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3421
Practice Address - Country:US
Practice Address - Phone:513-770-4212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical