Provider Demographics
NPI:1376209825
Name:HARRIS, TANYA MICHELE
Entity Type:Individual
Prefix:MISS
First Name:TANYA
Middle Name:MICHELE
Last Name:HARRIS
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 1:3169 SWEET GUM DR
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-1628
Mailing Address - Country:US
Mailing Address - Phone:504-319-9261
Mailing Address - Fax:
Practice Address - Street 1:3169 SWEET GUM DR
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-1628
Practice Address - Country:US
Practice Address - Phone:504-319-9261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care