Provider Demographics
NPI:1790009496
Name:HARRIS, LENORE S (NP)
Entity Type:Individual
Prefix:
First Name:LENORE
Middle Name:S
Last Name:HARRIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 583
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70821-0583
Mailing Address - Country:US
Mailing Address - Phone:225-289-6803
Mailing Address - Fax:
Practice Address - Street 1:8585 PICARDY AVE
Practice Address - Street 2:STE 414
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3749
Practice Address - Country:US
Practice Address - Phone:225-763-4764
Practice Address - Fax:225-763-4549
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN070097363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner