Provider Demographics
NPI:1295285674
Name:TORRENCE, ATIYA JASMYNE (LPN)
Entity type:Individual
Prefix:
First Name:ATIYA
Middle Name:JASMYNE
Last Name:TORRENCE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ATIYA
Other - Middle Name:JASMYNE
Other - Last Name:HILLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:284 EXECUTIVE PARK DR
Mailing Address - Street 2:STE 100
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1831
Mailing Address - Country:US
Mailing Address - Phone:704-939-1100
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:1408 E FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-5160
Practice Address - Country:US
Practice Address - Phone:704-635-2080
Practice Address - Fax:704-635-2089
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC75176164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse