Individual
KENNETH L HARDING JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
1373 E STATE ROAD 62, MADISON, IN 47250-7328
(812) 801-0156
(812) 801-0276
Mailing address
PO BOX 189, MADISON, IN 47250-0189
(812) 801-0156
(812) 801-0276
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28080093
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000042218
ANTHEM BCBS
IN
05
—
200115220A
—
IN
01
—
41CR04P
SIHO
IN
01
—
430039086
MEDICARE RAILROAD
—
01
—
50003404
PASSPORT KY MEDICAID
KY
05
—
74290651
—
KY
Enumeration date
07/11/2006
Last updated
06/17/2013
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