Provider Demographics
NPI:1154382992
Name:PANIAGUA TORRES, CARMEN T (EDD, ACNP/APNG/FAANP)
Entity type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:T
Last Name:PANIAGUA TORRES
Suffix:
Gender:F
Credentials:EDD, ACNP/APNG/FAANP
Other - Prefix:DR
Other - First Name:CARMEN
Other - Middle Name:T
Other - Last Name:PANIAGUA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:EDD, ACNP/APNG/FAANP
Mailing Address - Street 1:4301 WEST MARKHAM ST.
Mailing Address - Street 2:SLOT 584
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-4928
Mailing Address - Country:US
Mailing Address - Phone:501-686-5515
Mailing Address - Fax:
Practice Address - Street 1:4301 W MARKHAM ST # 783
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-686-8708
Practice Address - Fax:501-686-8350
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA02968363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR177646758Medicaid
AR177646758Medicaid