MEDICARE: JENNY M DOYLE NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	645101	NY
2	363LF0000X	Family Nurse Practitioner	338514	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518234640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNY M DOYLE NP

Provider Business Mailing Address
First Line	:	75 WASHINGTON ST
Second Line	:
City	:	POUGHKEEPSIE
State	:	NY
Zip	:	12601-2303
Country	:	US
Telephone Number	:	845-790-7990
Fax Number	:	845-790-9036

Provider Business Practice Location Address
First Line	:	75 WASHINGTON ST
Second Line	:
City	:	POUGHKEEPSIE
State	:	NY
Zip	:	12601-2303
Country	:	US
Telephone Number	:	845-790-7990
Fax Number	:	845-790-9036

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2011
Last Update Date	:	03/10/2021

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