Provider Demographics
NPI:1942872056
Name:DOYLE, ELLEN (APRN)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11871 PLAZA DR UNIT 3
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-7450
Mailing Address - Country:US
Mailing Address - Phone:843-750-0324
Mailing Address - Fax:
Practice Address - Street 1:11871 PLAZA DR UNIT 3
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-7450
Practice Address - Country:US
Practice Address - Phone:843-750-0324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN.25198363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily