Provider Demographics
NPI:1134356462
Name:HARMON, DAMIKA RENEE' (DNP, APRN, NP-C)
Entity type:Individual
Prefix:DR
First Name:DAMIKA
Middle Name:RENEE'
Last Name:HARMON
Suffix:
Gender:F
Credentials:DNP, APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 HENDERSON FOREST DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-2259
Mailing Address - Country:US
Mailing Address - Phone:337-502-8070
Mailing Address - Fax:337-478-5926
Practice Address - Street 1:1409 KIRKMAN ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-5344
Practice Address - Country:US
Practice Address - Phone:337-502-8070
Practice Address - Fax:337-478-5926
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05818363LA2200X
LARN094877-AP05818363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1812986Medicaid