Healthcare Provider Details

I. General information

NPI: 1689505414
Provider Name (Legal Business Name): TORRIA MICHELLE LANDRY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 W MAIN ST
HAMPTON GA
30228-2187
US

IV. Provider business mailing address

2 W MAIN ST
HAMPTON GA
30228-2187
US

V. Phone/Fax

Practice location:
  • Phone: 770-507-7772
  • Fax:
Mailing address:
  • Phone: 770-507-7772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN196557
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: