Provider Demographics
NPI:1528127966
Name:DOYLE, TERI (CNP)
Entity type:Individual
Prefix:MS
First Name:TERI
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 SAINT MICHAELS DR STE B104
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-7671
Mailing Address - Country:US
Mailing Address - Phone:505-992-3334
Mailing Address - Fax:505-992-1998
Practice Address - Street 1:435 SAINT MICHAELS DR STE B104
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-7671
Practice Address - Country:US
Practice Address - Phone:505-992-3334
Practice Address - Fax:505-992-1998
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR49108363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMR49108OtherSTATE LICENSE