MEDICARE: DR. AMANDA LYNNE HARDING MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	50141	CO
2	208000000X	Pediatrics Physician	50141	CO
3	208000000X	Pediatrics Physician	C1-0025959	DE
4	208000000X	Pediatrics Physician	4301083796	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255543179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA LYNNE HARDING MD

Provider Business Mailing Address
First Line	:	4650 SIGNAL TREE DR UNIT 400
Second Line	:
City	:	TIMNATH
State	:	CO
Zip	:	80547-4902
Country	:	US
Telephone Number	:	970-812-9927
Fax Number	:

Provider Business Practice Location Address
First Line	:	4650 SIGNAL TREE DR UNIT 400
Second Line	:
City	:	TIMNATH
State	:	CO
Zip	:	80547-4902
Country	:	US
Telephone Number	:	970-812-9927
Fax Number	:	970-999-8655

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	10/11/2025

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