Healthcare Provider Details

I. General information

NPI: 1194293399
Provider Name (Legal Business Name): KELSEY ANN DOYLE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 CHURCHMANS RD
NEWARK DE
19702-1937
US

IV. Provider business mailing address

665 CHURCHMANS RD
NEWARK DE
19702-1918
US

V. Phone/Fax

Practice location:
  • Phone: 302-731-0900
  • Fax:
Mailing address:
  • Phone: 302-731-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0049617
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberLG-0001191
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0001191
License Number StateDE
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0049617
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: