Provider Demographics
NPI:1134192743
Name:DOYLE, JULIE A (PA-C)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:DOYLE
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:WAUKESHA HEALTH CARE INC.
Mailing Address - Street 2:N17 W24100 RIVERWOOD DRIVE SUITE 250
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1177
Mailing Address - Country:US
Mailing Address - Phone:262-928-4100
Mailing Address - Fax:262-928-5835
Practice Address - Street 1:PROHEALTH CARE MEDICAL CENTER-MUKWONAGO
Practice Address - Street 2:240 MAPLE AVENUE
Practice Address - City:MUKWONAGO
Practice Address - State:WI
Practice Address - Zip Code:53149
Practice Address - Country:US
Practice Address - Phone:262-928-1900
Practice Address - Fax:262-363-1949
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2008-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI795363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42967800Medicaid
WIS41168Medicare UPIN