Healthcare Provider Details

I. General information

NPI: 1124674098
Provider Name (Legal Business Name): JAMIE TORRES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2019
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3246 MONTGOMERY HWY STE 202
DOTHAN AL
36303-2102
US

IV. Provider business mailing address

3246 MONTGOMERY HWY STE 202
DOTHAN AL
36303-2102
US

V. Phone/Fax

Practice location:
  • Phone: 334-446-4626
  • Fax: 334-203-9748
Mailing address:
  • Phone: 334-446-4626
  • Fax: 334-203-9748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-144738
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-144738
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-144738
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: