Provider Demographics
NPI:1073592432
Name:DOYLE, CHRISTINE LORRAINE (ARNP, CPNP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LORRAINE
Last Name:DOYLE
Suffix:
Gender:F
Credentials:ARNP, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 A AVE E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OSKALOOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52577-4202
Mailing Address - Country:US
Mailing Address - Phone:641-673-7537
Mailing Address - Fax:641-673-5235
Practice Address - Street 1:1417 A AVE E
Practice Address - Street 2:SUITE 100
Practice Address - City:OSKALOOSA
Practice Address - State:IA
Practice Address - Zip Code:52577-4202
Practice Address - Country:US
Practice Address - Phone:641-673-7537
Practice Address - Fax:641-673-5235
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAC-068696363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA3419721Medicaid
IA03077OtherWELLMARK
IA03077OtherWELLMARK
IAI16567Medicare ID - Type Unspecified