Provider Demographics
NPI:1588612246
Name:TORRES, DEBORAH L (CRNP)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:L
Last Name:TORRES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PUBLIC SQ STE 600
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18701-1704
Mailing Address - Country:US
Mailing Address - Phone:570-826-1777
Mailing Address - Fax:570-823-3040
Practice Address - Street 1:15 PUBLIC SQ STE 600
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18701-1704
Practice Address - Country:US
Practice Address - Phone:570-826-1777
Practice Address - Fax:570-823-3040
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP004540G363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
S64045Medicare UPIN
PA019002Medicare ID - Type Unspecified