Doctor Name: | IRENE TORRES |
NPI Number: | 1083079008 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 71005974A |
Business Practice Address: | 2421 Laporte Ave Valparaiso, IN - 463836914 |
Business Phone Number: | 2194626192 |
Business Fax Number: | 2194642585 |
Mailing Address: | 1040 Sierra Dr, Ste 400 GREENWOOD |
State: | IN |
Postal Code: | 461437240 |
Phone Number: | 3175284259 |
Fax Number: | 3178658324 |
NPI Enumeration Date: | 12/17/2015 |
NPI Last Update Date: | 12/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 71005974A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |