Basic Information
Provider Information
NPI: 1871914358
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOYLE
FirstName: MARY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 41 UNIVERSITY DR STE 300
Address2:  
City: NEWTOWN
State: PA
PostalCode: 189401873
CountryCode: US
TelephoneNumber: 2157107037
FaxNumber: 2157105181
Practice Location
Address1: 1205 LANGHRN NWTWN RD STE 108
Address2:  
City: LANGHORNE
State: PA
PostalCode: 19047
CountryCode: US
TelephoneNumber: 2157102224
FaxNumber: 2157106007
Other Information
ProviderEnumerationDate: 12/30/2013
LastUpdateDate: 08/14/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200XSP006460CPAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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