Provider Demographics
NPI:1053713503
Name:HARRIS, DIANNE (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5521 MAPLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70129-2901
Mailing Address - Country:US
Mailing Address - Phone:504-559-5788
Mailing Address - Fax:
Practice Address - Street 1:517 N RAMPART ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-3503
Practice Address - Country:US
Practice Address - Phone:504-658-2554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-16
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN046791163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health