Individual
AMANDA IDDINS HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10100 GOODWOOD BLVD, BATON ROUGE, LA 70815-4521
(225) 924-7707
(225) 926-9467
Mailing address
PO BOX 54466, NEW ORLEANS, LA 70154-4466
(225) 765-5727
(225) 765-4278
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN107544AP06096
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00879558
—
MS
05
—
2113259
—
LA
Enumeration date
03/16/2010
Last updated
10/29/2024
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