Provider Demographics
NPI:1689371718
Name:TORRES, MOLLY ANN (APRN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:ANN
Last Name:TORRES
Suffix:
Gender:F
Credentials:APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 AMANDA LN
Mailing Address - Street 2:
Mailing Address - City:KILGORE
Mailing Address - State:TX
Mailing Address - Zip Code:75662-4525
Mailing Address - Country:US
Mailing Address - Phone:817-876-8271
Mailing Address - Fax:
Practice Address - Street 1:103 W LOOP 281 STE 464
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-4653
Practice Address - Country:US
Practice Address - Phone:903-230-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1109968363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics