MEDICARE: MRS. IFE I TORRENCE FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0024172055	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C06695	OTHER	VA	GROUP PTAN

General Provider Information

NPI Number	:	1699176115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. IFE I TORRENCE FNP-C

Provider Business Mailing Address
First Line	:	1510 N 28TH ST STE 308
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-5311
Country	:	US
Telephone Number	:	804-644-1665
Fax Number	:	804-644-5285

Provider Business Practice Location Address
First Line	:	1510 N 28TH ST
Second Line	:	SUITE 308
City	:	RICHMOND
State	:	VA
Zip	:	23223-5311
Country	:	US
Telephone Number	:	804-644-1665
Fax Number	:	804-644-5285

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2014
Last Update Date	:	01/08/2026

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