Provider Demographics
NPI:1376081158
Name:TORRES, MARYAN D (APNP)
Entity Type:Individual
Prefix:
First Name:MARYAN
Middle Name:D
Last Name:TORRES
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1433 N WATER ST STE 400
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-2603
Mailing Address - Country:US
Mailing Address - Phone:414-502-9006
Mailing Address - Fax:877-890-7765
Practice Address - Street 1:1433 N WATER ST STE 400
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2603
Practice Address - Country:US
Practice Address - Phone:414-502-9006
Practice Address - Fax:877-890-7765
Is Sole Proprietor?:No
Enumeration Date:2017-02-01
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7523-33363LF0000X, 363LP0808X
CA95020409363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily