Healthcare Provider Details

I. General information

NPI: 1205343803
Provider Name (Legal Business Name): TONETTE HARRIS-HAYNES PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2018
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 ROBERTS DR STE H
NEW ROADS LA
70760-2661
US

IV. Provider business mailing address

6450 LA HIGHWAY 1 STE B
BATCHELOR LA
70715-3212
US

V. Phone/Fax

Practice location:
  • Phone: 225-618-7800
  • Fax: 225-238-8330
Mailing address:
  • Phone: 225-618-5015
  • Fax: 225-442-3107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP09251
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP09251
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: