Healthcare Provider Details

I. General information

NPI: 1154286458
Provider Name (Legal Business Name): MICHELLE MURIEL DOYLE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3833 MOANA WAY APT B
SANTA CRUZ CA
95062-5253
US

IV. Provider business mailing address

3833 MOANA WAY APT B
SANTA CRUZ CA
95062-5253
US

V. Phone/Fax

Practice location:
  • Phone: 831-234-6790
  • Fax:
Mailing address:
  • Phone: 831-234-6790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number718511
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: