Provider Demographics
NPI:1720818198
Name:MAHROUS, TORRI RAYNE (FNP)
Entity type:Individual
Prefix:
First Name:TORRI
Middle Name:RAYNE
Last Name:MAHROUS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6573 HIGHWAY 33
Mailing Address - Street 2:
Mailing Address - City:FARMERVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71241-4931
Mailing Address - Country:US
Mailing Address - Phone:225-588-4916
Mailing Address - Fax:
Practice Address - Street 1:1117 CHENIERE DREW RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-8551
Practice Address - Country:US
Practice Address - Phone:318-692-5662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA205709363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily