Provider Demographics
NPI:1639977549
Name:DOYLE, MELINDA GRACE
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:GRACE
Last Name:DOYLE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 RAWHIDE RD
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:WY
Mailing Address - Zip Code:82636-9709
Mailing Address - Country:US
Mailing Address - Phone:307-259-3589
Mailing Address - Fax:
Practice Address - Street 1:710 RAWHIDE RD
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:WY
Practice Address - Zip Code:82636-9709
Practice Address - Country:US
Practice Address - Phone:307-259-3589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator