Provider Demographics
NPI:1356397426
Name:DOYLE, MARJORIE JUNE (RN)
Entity type:Individual
Prefix:MS
First Name:MARJORIE
Middle Name:JUNE
Last Name:DOYLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:MARJORIE
Other - Middle Name:JUNE
Other - Last Name:COOPERIDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:824 SENIOR WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-2129
Mailing Address - Country:US
Mailing Address - Phone:916-391-6196
Mailing Address - Fax:
Practice Address - Street 1:4600 BROADWAY
Practice Address - Street 2:STE 1100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820
Practice Address - Country:US
Practice Address - Phone:916-874-2554
Practice Address - Fax:916-874-2717
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA160825163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse