Provider Demographics
NPI:1205343803
Name:HARRIS-HAYNES, TONETTE (PMHNP)
Entity type:Individual
Prefix:
First Name:TONETTE
Middle Name:
Last Name:HARRIS-HAYNES
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:SICILY ISLAND
Mailing Address - State:LA
Mailing Address - Zip Code:71368-0008
Mailing Address - Country:US
Mailing Address - Phone:318-389-5727
Mailing Address - Fax:318-389-9943
Practice Address - Street 1:230 ROBERTS DR STE H
Practice Address - Street 2:
Practice Address - City:NEW ROADS
Practice Address - State:LA
Practice Address - Zip Code:70760-2661
Practice Address - Country:US
Practice Address - Phone:225-618-7800
Practice Address - Fax:225-238-8330
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04677363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2488651Medicaid