Individual
TYNESE JANEY HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 W UNIVERSITY AVE, HAMMOND, LA 70401-1304
(985) 549-2000
Mailing address
8877 HOUMA DR, LA PLACE, LA 70068-6006
(504) 939-7204
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2001881844781
—
LA
Enumeration date
02/28/2019
Last updated
02/28/2019
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