Provider Demographics
NPI:1104325075
Name:DOYLE, PATTY ANN (PHARMD, BCGP)
Entity type:Individual
Prefix:DR
First Name:PATTY
Middle Name:ANN
Last Name:DOYLE
Suffix:
Gender:F
Credentials:PHARMD, BCGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8712 SANDRO RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55438-1229
Mailing Address - Country:US
Mailing Address - Phone:612-396-4974
Mailing Address - Fax:612-396-4974
Practice Address - Street 1:8712 SANDRO RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55438-1229
Practice Address - Country:US
Practice Address - Phone:612-396-4974
Practice Address - Fax:612-396-4974
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1174391835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatricGroup - Multi-Specialty