Provider Demographics
NPI:1356052757
Name:TORREALBA, HERIBERTO ENRIQUE (FNP)
Entity type:Individual
Prefix:
First Name:HERIBERTO
Middle Name:ENRIQUE
Last Name:TORREALBA
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 RADIO RD
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677-3351
Mailing Address - Country:US
Mailing Address - Phone:704-928-5630
Mailing Address - Fax:
Practice Address - Street 1:1104 RADIO RD
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-3351
Practice Address - Country:US
Practice Address - Phone:704-928-5630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCTORR-49GYU363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily