Provider Demographics
NPI:1184940355
Name:TORRENCE, SHANITA DANIELLE (APRN)
Entity type:Individual
Prefix:MS
First Name:SHANITA
Middle Name:DANIELLE
Last Name:TORRENCE
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8507 OCEANMIST COVE DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5028
Mailing Address - Country:US
Mailing Address - Phone:206-854-6602
Mailing Address - Fax:
Practice Address - Street 1:8102 FRY RD STE A
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7077
Practice Address - Country:US
Practice Address - Phone:206-854-6602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-13
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1195721363LP0808X
CA769409163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse