Healthcare Provider Details

I. General information

NPI: 1669081345
Provider Name (Legal Business Name): KRISTI B HARBIT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2020
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 S MAIN ST
FORT SCOTT KS
66701-1414
US

IV. Provider business mailing address

302 N HOSPITAL DR
GIRARD KS
66743-2000
US

V. Phone/Fax

Practice location:
  • Phone: 202-224-2627
  • Fax: 620-224-2453
Mailing address:
  • Phone: 620-224-2627
  • Fax: 620-224-2453

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number80234
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number13-111700-111
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: