Provider Demographics
NPI:1790047835
Name:DOYLE, DOLLORES LOUISE (RN)
Entity Type:Individual
Prefix:
First Name:DOLLORES
Middle Name:LOUISE
Last Name:DOYLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4154 DOWLING RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-7338
Mailing Address - Country:US
Mailing Address - Phone:904-406-4265
Mailing Address - Fax:
Practice Address - Street 1:4154 DOWLING RD
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-7338
Practice Address - Country:US
Practice Address - Phone:904-406-4265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9214143163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse