Provider Demographics
NPI:1194293159
Name:TORRES, DIANA SUJEY (MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:SUJEY
Last Name:TORRES
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11310 PALMILLAS LOOP
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-2820
Mailing Address - Country:US
Mailing Address - Phone:956-265-2139
Mailing Address - Fax:
Practice Address - Street 1:1121 HARLAN ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6698
Practice Address - Country:US
Practice Address - Phone:956-750-2055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139653363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily