Provider Demographics
NPI:1467190157
Name:TORRES, JAZMINE ALEAH
Entity Type:Individual
Prefix:
First Name:JAZMINE
Middle Name:ALEAH
Last Name:TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 RUEMMELE RD APT 218
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6300
Mailing Address - Country:US
Mailing Address - Phone:701-330-9637
Mailing Address - Fax:
Practice Address - Street 1:1215 N 39TH ST APT 107
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58203-2055
Practice Address - Country:US
Practice Address - Phone:701-885-1114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant