Individual
MATILDE HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 MEDICAL CENTER BLVD, MARRERO, LA 70072-3147
(504) 900-8533
Mailing address
308 ALAN CIR, SLIDELL, LA 70458-6502
(601) 347-8780
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
229456
LA
Other
Enumeration date
02/10/2023
Last updated
02/10/2023
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