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General NPI Number Information
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NPI Number | 1235017054
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Entity Type | Individual
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Provider Name | KIMBERLY C HARBISON RD
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Gender | Female
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 3340 PROVIDENCE DR STE A453
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City | ANCHORAGE
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State | AK
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Zip | 99508-4691
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Country | US
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Telephone | 907-212-7982
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Fax | 907-212-7981
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Provider Business Mailing Address
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Address Line | PO BOX 31001-4166
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City | PASADENA
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State | CA
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Zip | 91110-4166
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Country | US
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Telephone | 907-212-7982
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Fax | 907-212-7981
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 164902
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License Number State | AK
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