Healthcare Provider Details

I. General information

NPI: 1649887878
Provider Name (Legal Business Name): KIMBERLY DANIELLE HARDING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2020
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 W MAIN ST
SALTVILLE VA
24370-3112
US

IV. Provider business mailing address

PO BOX 729
SALTVILLE VA
24370-0729
US

V. Phone/Fax

Practice location:
  • Phone: 276-496-4433
  • Fax: 276-496-0057
Mailing address:
  • Phone: 276-496-4492
  • Fax: 276-496-0057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024180270
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: