Provider Demographics
NPI:1568640001
Name:DOYLE, LOIS BRIDGEWATER (CNM, FNP-C)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:BRIDGEWATER
Last Name:DOYLE
Suffix:
Gender:F
Credentials:CNM, FNP-C
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:L
Other - Last Name:BRIDGEWATER-SMITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN, CNM, FNP-C
Mailing Address - Street 1:PO BOX 66156
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70896-6156
Mailing Address - Country:US
Mailing Address - Phone:225-264-6800
Mailing Address - Fax:
Practice Address - Street 1:3140 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3757
Practice Address - Country:US
Practice Address - Phone:225-264-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA85627-5034/ AP05034363LF0000X
LARN085627367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2167952Medicaid