Provider Demographics
NPI:1750036307
Name:DOYLE, LAUREN
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:MALAGA
Mailing Address - State:NJ
Mailing Address - Zip Code:08328-4124
Mailing Address - Country:US
Mailing Address - Phone:856-776-1593
Mailing Address - Fax:
Practice Address - Street 1:2 READS WAY STE 201
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-1630
Practice Address - Country:US
Practice Address - Phone:302-709-4709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-12
Last Update Date:2022-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJL6-0A10870367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered