Basic Information
Provider Information | |||||||||
NPI: | 1306040902 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | YANCI TORRES | ||||||||
FirstName: | MARTHA | ||||||||
MiddleName: | CECILIA | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 300 20TH AVE N STE 403 | ||||||||
Address2: |   | ||||||||
City: | NASHVILLE | ||||||||
State: | TN | ||||||||
PostalCode: | 372035180 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6152847224 | ||||||||
FaxNumber: | 6152847501 | ||||||||
Practice Location | |||||||||
Address1: | 1700 MEDICAL CENTER PKWY | ||||||||
Address2: |   | ||||||||
City: | MURFREESBORO | ||||||||
State: | TN | ||||||||
PostalCode: | 371292245 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6153964100 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/14/2007 | ||||||||
LastUpdateDate: | 02/01/2019 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 60082287 | WA | N |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 207T00000X | BP1-0022194 | TX | N |   | Allopathic & Osteopathic Physicians | Neurological Surgery |   | 2084N0400X | 103755 | MN | N |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084S0012X | 58510 | TN | Y |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Sleep Medicine |
ID Information
ID | Type | State | Issuer | Description | 2772886936 | 01 |   | MYUTMB 2772886936-COMMERCIAL NUMBER | OTHER | ENROLLED | 05 | MN |   | MEDICAID | P00645881 | 01 | MN | MEDICARE, RAILROAD | OTHER |