Provider Demographics
NPI:1063301927
Name:CHARLES-MORRIS, TANYA TENNIELLE
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:TENNIELLE
Last Name:CHARLES-MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:GRAMERCY
Mailing Address - State:LA
Mailing Address - Zip Code:70052-0005
Mailing Address - Country:US
Mailing Address - Phone:225-206-1002
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 5
Practice Address - Street 2:
Practice Address - City:GRAMERCY
Practice Address - State:LA
Practice Address - Zip Code:70052-0005
Practice Address - Country:US
Practice Address - Phone:225-206-1002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-02
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN122140163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health