Provider Demographics
NPI:1689979460
Name:DOYLE, TMOTHY DANIEL (ARNP)
Entity Type:Individual
Prefix:MR
First Name:TMOTHY
Middle Name:DANIEL
Last Name:DOYLE
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2624 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-5845
Mailing Address - Country:US
Mailing Address - Phone:319-277-1990
Mailing Address - Fax:319-277-0572
Practice Address - Street 1:2624 ORCHARD DR
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-5845
Practice Address - Country:US
Practice Address - Phone:319-277-1990
Practice Address - Fax:319-277-0572
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-117660363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1689979460Medicaid
IAP01086957OtherRR MEDICARE
IA719260219Medicare PIN