Provider Demographics
NPI:1912654658
Name:DICKENS, TORRY (NP)
Entity type:Individual
Prefix:
First Name:TORRY
Middle Name:
Last Name:DICKENS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 W MCNEESE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-5528
Mailing Address - Country:US
Mailing Address - Phone:337-721-9992
Mailing Address - Fax:337-721-9902
Practice Address - Street 1:540 W MCNEESE ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5528
Practice Address - Country:US
Practice Address - Phone:337-721-9992
Practice Address - Fax:337-721-9902
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA223686363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily