Provider Demographics
NPI:1245430248
Name:DOYLE, PAULA ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:ANN
Last Name:DOYLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:PAULA
Other - Middle Name:ANN
Other - Last Name:SLACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:128 CEDARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617
Mailing Address - Country:US
Mailing Address - Phone:585-338-9783
Mailing Address - Fax:
Practice Address - Street 1:128 CEDARWOOD RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617
Practice Address - Country:US
Practice Address - Phone:585-338-9783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4910681163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse