Provider Demographics
NPI:1922756519
Name:TORRES, ALEXIS VALDES (LPN)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:VALDES
Last Name:TORRES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4906 LOMBARD LN
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-4316
Mailing Address - Country:US
Mailing Address - Phone:571-205-7825
Mailing Address - Fax:
Practice Address - Street 1:147 GARRISONVILLE RD
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-1523
Practice Address - Country:US
Practice Address - Phone:571-205-7825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002098655164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse