| Doctor Name: | MRS. TORI MANUEL MIRE |
| NPI Number: | 1255546230 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP |
| License Number: | AP05182 |
| Business Practice Address: | 1413 7th St Suite B Mamou, LA - 705542214 |
| Business Phone Number: | 3374683306 |
| Business Fax Number: | 3374683322 |
| Mailing Address: | 5453 Vidrine Rd, VILLE PLATTE |
| State: | LA |
| Postal Code: | 705868715 |
| Phone Number: | 3373211738 |
| Fax Number: | 3374683322 |
| NPI Enumeration Date: | 05/11/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | AP05182 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |