Provider Demographics
NPI:1427215268
Name:DOYLE, TIFFANY ANN (APN-CNP)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ANN
Last Name:DOYLE
Suffix:
Gender:F
Credentials:APN-CNP
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:ANN
Other - Last Name:BENFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN
Mailing Address - Street 1:PO BOX 602108
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2108
Mailing Address - Country:US
Mailing Address - Phone:843-792-6200
Mailing Address - Fax:
Practice Address - Street 1:1003 LANDFALL WAY
Practice Address - Street 2:BTE B
Practice Address - City:SEABROOK ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455
Practice Address - Country:US
Practice Address - Phone:843-768-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24780363L00000X
IL209-004621363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP92823Medicare UPIN