Provider Demographics
NPI:1144570847
Name:MASSEY, TORRE (NP)
Entity Type:Individual
Prefix:
First Name:TORRE
Middle Name:
Last Name:MASSEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PRESTON CT
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-5772
Mailing Address - Country:US
Mailing Address - Phone:478-745-2385
Mailing Address - Fax:478-745-1225
Practice Address - Street 1:101 PRESTON CT
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-5772
Practice Address - Country:US
Practice Address - Phone:478-745-2385
Practice Address - Fax:478-745-1225
Is Sole Proprietor?:No
Enumeration Date:2012-09-11
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA195079363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner