Provider Demographics
NPI:1407307036
Name:STANLEY, DOYLE II (RN)
Entity Type:Individual
Prefix:MR
First Name:DOYLE
Middle Name:
Last Name:STANLEY
Suffix:II
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 N 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS
Mailing Address - State:AZ
Mailing Address - Zip Code:85349
Mailing Address - Country:US
Mailing Address - Phone:928-502-6138
Mailing Address - Fax:928-502-6223
Practice Address - Street 1:1250 N. 8TH AVE
Practice Address - Street 2:
Practice Address - City:SAN LUIS
Practice Address - State:AZ
Practice Address - Zip Code:85359-0000
Practice Address - Country:US
Practice Address - Phone:928-502-6138
Practice Address - Fax:928-502-6223
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN191523163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool