MEDICARE: TORRI RAYNE MAHROUS FNP

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	205709	LA

General Provider Information

NPI Number	:	1720818198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TORRI RAYNE MAHROUS FNP

Provider Business Mailing Address
First Line	:	6573 HIGHWAY 33
Second Line	:
City	:	FARMERVILLE
State	:	LA
Zip	:	71241-4931
Country	:	US
Telephone Number	:	225-588-4916
Fax Number	:

Provider Business Practice Location Address
First Line	:	1117 CHENIERE DREW RD
Second Line	:
City	:	WEST MONROE
State	:	LA
Zip	:	71291-8551
Country	:	US
Telephone Number	:	318-692-5662
Fax Number	:

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

Provider Enumeration Date	:	08/01/2024
Last Update Date	:	08/01/2024

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