Individual
MRS. AMANDA LEBLANC HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11295 E TAYLOR RD, GULFPORT, MS 39503-4197
(228) 864-3300
(228) 864-3333
Mailing address
PO BOX 6625, GULFPORT, MS 39506-6625
(504) 391-5454
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/11/2017
Last updated
04/09/2021
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