Provider Demographics
NPI:1083116255
Name:DOYLE, MARTHA JEAN (LVN)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:JEAN
Last Name:DOYLE
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:JEAN
Other - Last Name:LIVELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1302 S LONS ST
Mailing Address - Street 2:
Mailing Address - City:BROWNFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:79316-6726
Mailing Address - Country:US
Mailing Address - Phone:806-891-7612
Mailing Address - Fax:
Practice Address - Street 1:1302 S LONS ST
Practice Address - Street 2:
Practice Address - City:BROWNFIELD
Practice Address - State:TX
Practice Address - Zip Code:79316-6726
Practice Address - Country:US
Practice Address - Phone:806-891-7612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX230819164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse