Provider Demographics
NPI:1821840299
Name:HARRIS, LATOUSHA ELAINE
Entity type:Individual
Prefix:
First Name:LATOUSHA
Middle Name:ELAINE
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 1:5501 MONTEGUT DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-2352
Mailing Address - Country:US
Mailing Address - Phone:225-306-8488
Mailing Address - Fax:
Practice Address - Street 1:5501 MONTEGUT DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-2352
Practice Address - Country:US
Practice Address - Phone:225-306-8488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA30005373164W00000X
FLPN5255862164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty