Provider Demographics
NPI:1144661927
Name:DOYLE, TAMMY SUE
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:SUE
Last Name:DOYLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 CAMDEN WEST ELKTON RD
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:OH
Mailing Address - Zip Code:45311-9507
Mailing Address - Country:US
Mailing Address - Phone:937-452-6020
Mailing Address - Fax:
Practice Address - Street 1:322 CAMDEN WEST ELKTON RD
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:OH
Practice Address - Zip Code:45311-9507
Practice Address - Country:US
Practice Address - Phone:937-452-6020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN090315MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse