Provider Demographics
NPI:1972088490
Name:DOYLE, JESSICA (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:258 BEN FRANKLIN HWY E
Mailing Address - Street 2:
Mailing Address - City:BIRDSBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19508-8772
Mailing Address - Country:US
Mailing Address - Phone:610-288-2908
Mailing Address - Fax:610-898-4832
Practice Address - Street 1:1950 STREET RD STE 100
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-3749
Practice Address - Country:US
Practice Address - Phone:215-639-7546
Practice Address - Fax:215-639-0737
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2019-07-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00487900363A00000X
PAMA060381363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant