Healthcare Provider Details

I. General information

NPI: 1851425888
Provider Name (Legal Business Name): NANCY DOYLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY E DOYLE MD

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 09/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3324 CHANATE RD
SANTA ROSA CA
95404-1708
US

IV. Provider business mailing address

3420 MONTECITO AVE
SANTA ROSA CA
95404-2627
US

V. Phone/Fax

Practice location:
  • Phone: 707-576-4498
  • Fax: 707-576-4087
Mailing address:
  • Phone: 707-576-4498
  • Fax: 707-576-4087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG25592
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: