Provider Demographics
NPI:1639781248
Name:DOYLE, JUDITH ANN (RPH)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:DOYLE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 N 81ST ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-1015
Mailing Address - Country:US
Mailing Address - Phone:414-687-4035
Mailing Address - Fax:
Practice Address - Street 1:9130 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-2623
Practice Address - Country:US
Practice Address - Phone:414-258-9550
Practice Address - Fax:414-258-1088
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10311-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist