Provider Demographics
NPI:1417320581
Name:DOYLE, INDRE BESASPARYTE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:INDRE
Middle Name:BESASPARYTE
Last Name:DOYLE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:INDRE
Other - Middle Name:
Other - Last Name:BESASPARYTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1415 S DIVISION ST
Mailing Address - Street 2:SUITE A, PENINSULA REGIONAL ENDOCRINOLOGY
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-7291
Mailing Address - Country:US
Mailing Address - Phone:410-572-8848
Mailing Address - Fax:410-572-6890
Practice Address - Street 1:1415 S DIVISION ST
Practice Address - Street 2:SUITE A, PENINSULA REGIONAL ENDOCRINOLOGY
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-7291
Practice Address - Country:US
Practice Address - Phone:410-572-8848
Practice Address - Fax:410-572-6890
Is Sole Proprietor?:No
Enumeration Date:2015-11-11
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC001663363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily