Provider Demographics
NPI:1083329072
Name:DOYLE, KALI LOUISE (MSN, APRN, PNP-PC)
Entity Type:Individual
Prefix:
First Name:KALI
Middle Name:LOUISE
Last Name:DOYLE
Suffix:
Gender:F
Credentials:MSN, APRN, PNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 S LEGACY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-6038
Mailing Address - Country:US
Mailing Address - Phone:847-707-5948
Mailing Address - Fax:
Practice Address - Street 1:759 E HOLLAND AVE UNIT 101
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1257
Practice Address - Country:US
Practice Address - Phone:509-270-0065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61381890363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics